Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Background: Chronic Pancreatitis (CP) in children is rare and experience of ERCP in children withCP is limited. Aim: Safety and efficacy of ERCP for the treatment of CP in children were evaluated Patients & methods: Retrospective identification of CP pediatric patients who underwent ERCP.Indications, findings, treatment modalities, adverse events/outcomes were recorded during longterm follow-up Results: Of the 125 children that underwent ERCP, 35(28%) had CP (16 boys, mean 11.6 yrs [2.5-17]).Indications for ERCP were recurrent bouts of pancreatitis/pain. 19(54.3%) had pancreaticstones/plugs, 10(28.5%) had pancreas divisum, 6(17.1%) had dominant Santorini duct anatomy,17(48.5%) had gene mutations related CP. Minor papilla sphincterotomy was done in 14 children;pancreatic Extracorporeal Shock Wave Lithotripsy had 3 children. Plastic stents were placed in 5 forduct strictures. ERCP complications (bleeding/pancreatitis) occurred in 2(5.7%). Mean follow-up 8yrs (0.7-21). 14(40%) had only one ERCP and were pain-free during 6 yrs (0.7-15) of follow-up;21(60%) had recurrence of pain after mean 4.6 yrs(0.8-20.4) and had additional ERCPs (75re-interventions[1-14; 3.5/pt]). 13 Children had re-sphincterotomy for sphincterotomy structure, andwere pain-free on followup (mean 3.6 yrs [0.3-5.6]). 16 had plugs on re-interventions; 1 boy had postre-sphincterotomy bleeding. Re-interventions were higher in females (p<0.01), and in younger than8 yrs(p<0.01). Pain recurrences were not related to MPD anatomy or genetic mutations (p=0.2 &p=0.3 respectively). Conclusion: ERCP in pediatric patients with CP is a safe and effective. In more than 1/3 of cases only 1ERCP can be resolved. Symptom recurrences can be easily managed with ERCP withoutmajor complications.

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