[Endoscopic treatment of idiopathic recurrent chronic pancreatitis in children and adolescents].

BACKGROUND

The use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is increasing in the management of pancreatobiliary diseases in children.

AIM: Report our experience with ERCP in the management of chronic recurrent idiopathic pancreatitis in children.

PATIENTS AND

METHODS

Over a 12-year period we performed 56 ERCP for the treatment of chronic recurrent idiopathic pancreatitis in 20 patients which clinical status was assessed six months before the first ERCP and six months after the last ERCP.

RESULTS

There were 12 girls and eight boys with a mean age of 11.36 in girls (range 4-17) and 12.77 in boys (range 9-16). Abdominal pain was the main presenting symptoms with hiperamylasemia. Clinical diagnoses included two pancreas divisum, chronic calcifying pancreatitis in two and 16 non-calcifying chronic pancreatitis with dilated and irregular pancreatic duct. The mean follow-up was 24 months. Twenty patients underwent a total of 56 therapeutic ERCP procedures included pancreatic and biliary sphincterotomy, pancreatic endoprosthesis placement, stone extraction and hydrostatic or mechanical dilation in pancreatic strictures. There were four complications of 56 procedures (7.14%), both being mild pancreatitis after endoprosthesis placement (n = 1), pancreatic sphincterotomy (n = 1) and hydrostatic dilation with endoprosthesis placement (n = 2). There were no deaths. There was a significant reduction in frequency and severity of pain after intervention (p < 0.001). One patient with calcifying pancreatitis required surgical intervention.

CONCLUSION

ERCP is safety and useful diagnostic and therapeutic procedure in children and adolescents with chronic recurrent idiopathic pancreatitis.