Endoscopic treatment of chronic pancreatitis in pediatric population: Long-term efficacy and safety

D. Kohoutova, A. Tringali, G. Papparella, V. Perri, I. Boškoski, J. Hamanaka, G. Costamagna

Research output: Contribution to journalArticle

Abstract

Background: Chronic pancreatitis (CP) in children is an inreasingly recognized disease. Objective: The purpose of study was to analyse the safety and long-term efficacy of endoscopic treatment in children with CP. Methods: Records of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico “A. Gemelli” IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre- and post- endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated. Results: In total 158 ERCPs were performed. Median post-ERCP follow-up was 7 years. The majority of patients had CP type IV (47%) and type Ib (37%) (Cremer’s classification). Major papilla pancreatic sphincterotomy was performed in 47%, major and minor in 24% and minor in 29% of patients. Stones/plugs were removed in at least one ERCPs in 66% individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3%). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery. Conclusion: Endoscopic management of symptomatic CP in children is safe and effective.

Original languageEnglish
JournalUnited European Gastroenterology Journal
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Endoscopic Retrograde Cholangiopancreatography
Chronic Pancreatitis
Pediatrics
Safety
Pancreatitis
Analgesia
Abdominal Pain
Population
Pancreatic Ducts
Therapeutics
Endoscopy
Pathologic Constriction

Keywords

  • Chronic pancreatitis
  • efficacy and safety
  • ERCP
  • pediatric population
  • personalized medicine

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Endoscopic treatment of chronic pancreatitis in pediatric population : Long-term efficacy and safety. / Kohoutova, D.; Tringali, A.; Papparella, G.; Perri, V.; Boškoski, I.; Hamanaka, J.; Costamagna, G.

In: United European Gastroenterology Journal, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Chronic pancreatitis (CP) in children is an inreasingly recognized disease. Objective: The purpose of study was to analyse the safety and long-term efficacy of endoscopic treatment in children with CP. Methods: Records of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico “A. Gemelli” IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre- and post- endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated. Results: In total 158 ERCPs were performed. Median post-ERCP follow-up was 7 years. The majority of patients had CP type IV (47{\%}) and type Ib (37{\%}) (Cremer’s classification). Major papilla pancreatic sphincterotomy was performed in 47{\%}, major and minor in 24{\%} and minor in 29{\%} of patients. Stones/plugs were removed in at least one ERCPs in 66{\%} individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3{\%}). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery. Conclusion: Endoscopic management of symptomatic CP in children is safe and effective.",
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