TY - JOUR
T1 - Endoscopic treatment of chronic pancreatitis in pediatric population: Long-term efficacy and safety
AU - Kohoutova, D.
AU - Tringali, Andrea
AU - Papparella, Luigi Giovanni
AU - Perri, Vincenzo
AU - Boskoski, Ivo
AU - Hamanaka, J.
AU - Costamagna, Guido
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Chronic pancreatitis
KW - ERCP
KW - Gastroenterology
KW - Oncology
KW - efficacy and safety
KW - pediatric population
KW - personalized medicine
KW - Chronic pancreatitis
KW - ERCP
KW - Gastroenterology
KW - Oncology
KW - efficacy and safety
KW - pediatric population
KW - personalized medicine
UR - http://hdl.handle.net/10807/136007
UR - http://ueg.sagepub.com/
U2 - 10.1177/2050640618817699
DO - 10.1177/2050640618817699
M3 - Article
SN - 2050-6406
VL - 7
SP - 270
EP - 277
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
ER -