Clinical features of chronic pancreatitis and clinical value of endoscopic retrograde cholangiopancreatography for pediatric population

Objective To study the clinical value and the safety of endoscopic retrograde cholangiopancreatography(ERCP) for chronic pancreatitis in the pediatric population. Methods Clinical data, endoscopic reports, and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan. 1, 2008 and Apr. 30, 2014 at Endoscopy Center of Ruijin Hospital were reviewed. These patients were divided into 3 groups, patients aged from 2 to 6 years old as children group(n=27), patients aged from 7 to 12 years old as juvenile group(n=35) and patients aged from 13 to 17 as adolescent group(n=25). Their clinical data and complications were analyzed by groups. Results A total of 170 ERCP procedures were performed in 87 patients, with the success rate of 99.4%(169/170). All patients were diagnosed as having chronic pancreatitis by ERCP. Success rates of children group, juvenile group and adolescent group were 97.6%(40/41), 100.0%(72/72) and 100.0%(57/57) respectively. There was no statistically significance among the three groups(P=0.207). No serious complications like bleeding or perforation occurred. No procedure-related mortality occurred in this study either. The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17/41), 25.0%(18/72) and 24.6%(14/57), respectively. Children group had more adverse events than the juvenile group(P=0.039) and adolescent group(P=0.045). Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children. Key words: Endoscopic retrograde cholangiopancreatography; Pediatric population; Chronic pancreatitis