Value of endoscopic retrograde cholangiopancreatography in the treatment of pancreatic diseases in children

Objective To explore the therapeutic value of endoscopic retrograde cholangiopancreatography （ERCP） for pancreatic diseases in children. Methods A total of 12 children aged from 10 momhs to 13. 3 years underwent therapeutic ERCP from 2007 to 2013. Primary diagnosis was made by type B-ultrasound, computed tomography （CT） or magnetic resonance imaging （MRI） and confirmed with ERCP. According to individual conditions, the suitable therapeutic approaches were selected, such as EST （endoscopic sphincterotomy）, EPS （endoscopic pancreatic sphincterotomy）, EPBD （endoscopic papillary balloon dilation）, ERBD （endoscopic retrograde biliary drainage）, ERPD （endoscopic retrograde pancreatic drainage） and ENPD （endoscopic naso-pancreatic drainage）. The leukocyte count and the activities of blood amylase were monitored at 3 h, 12 h and 24 h post-ERCP. Results Among them, the definite diagnoses were acute biliary pancreatitis （n - 3）, pancreatic divisum （n = 2）, pancreatic injury （n = 2）, pancreatic pseudocyst （n = 2）, chronic panereatitis （n= 2） and pancreatic duct stone （n = 1）. No severe complications occurred, such as massive gastrointestinal hemorrhage, digestive tract perforation, severe biliary infection and death. Post-ERCP pancreatitis was not noted. Two cases of hyperamylasemia were cured through conservation treatment and discharged. After a follow-up period of 14 to 77 months, clinical symptoms alleviated and weight gained in all cases. Abnormal dietary and altered bowel habits were not found. Liver function and serum amylase were normal on regular reexaminations. The physiological and intelligential developments were normal in all cases. Conclusions Therapeutic ERCP is mini-invasive,reliable, safe and effective in the treatment for some benign pancreatic diseases in children. But surgery is still required for thoroughly understanding the basic pathological changes of congenital biliary dilatation. Key words: Cholangiopancreatography, endoscopic retrograde;  Pancreatic diseases;  Surgicalprocedures, minimally invasive