Impact of ERCP on pancreatitis frequency in pediatric acute recurrent or chronic pancreatitis: An INSPPIRE‐2 study
Michael Joseph, Jacob A. Mark, Robert Adam Noe, Fuchenchu Wang, Gretchen A. Cress, Maisam Abu‐El‐Haija, Ankur Chugh, Reuven Zev Cohen, Elissa M. Downs, Douglas S. Fishman, A. Jay Freeman, Matthew J. Giefer, Tanja Gonska, Amit S. Grover, Andrew Y. J. Liman, Douglas Lindblad, Quin Y. Liu, Asim Maqbool, Brian A. McFerron, Megha S. Mehta, Veronique D. Morinville, Kenneth Ng, Chee Y. Ooi, Emily R. Perito, Feng Tian, Michael Wilschanski, Yuhua Zheng, Ying Yuan, Mark E. Lowe, Aliye Uc,Abstract
Objectives
Treatment options for pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are limited. We aim to quantify the response rate to endoscopic retrograde cholangiopancreatography (ERCP) and identify predictive factors that determine response in children with ARP or CP.
Methods
Data was obtained from the
Results
There were 436 children who underwent a total of 1504 ERCPs in our cohort. Eighty‐five patients (19.5%) had ARP; 351 (80.5%) had CP. Significant differences were noted between those who had ERCP and those who did not based on sex, BMI percentile and diagnosis. ERCP response rate was 70.0% ( n = 206). Patients with pancreatic duct calculi/obstruction were more likely to be ERCP responders ( p < 0.04).
Conclusions
ERCP was used commonly in the treatment of ARP/CP for children with any pancreatic duct abnormality. Two‐thirds of children responded well to endoscopic therapy with at least 50% decrease in AP attacks the year post‐initial ERCP; ductal calculi/obstruction were associated with higher rate of response. These results support that therapeutic ERCP is safe and may provide short to medium‐term therapeutic benefit in children with ARP or CP especially with ductal factors seen on pre‐intervention imaging.