Endoscopic diagnosis and treatment of pancreas divisum with recurrent acute pancreatitis in children and teenagers / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pancreas divisum(PD) associated with recurrent acute pancreatitis(RAP) in children and teenagers. Methods Data of patients with symptomatic PD associated with RAP under 18 years old who were diagnosed and treated with ERCP from January 2011 to January 2015 were retrospectively analyzed. Patients with complete pancreas divisum underwent endoscopic minor sphincterotomy combined with dorsal duct stenting ( ESCS ) , and those with incomplete pancreas divisum underwent bi?papilla endoscopic sphincterotomy combined with dorsal duct stenting ( Bi?ESCS ) . ERCP?related data, complications were recorded. Long?term follow?up was conducted for procedure related complications. Results Nine patients with symptomatic PD associated with RAP were firstly diagnosed. A total of 18 ERCP procedures were performed in these patients, with success rate of 100. 0% ( 18/18) in the minor papilla cannulation, and mild ERCP?related complication rate of 11. 1% ( 2/18) . One was acute mild pancreatitis and the other was hyperamylasemia. During follow?up from 3 to 60 months, all patients had pain relief, among whom 7 were asymptomatic, with no onset of acute pancreatitis. Dorsal ducts of all patients were not obviously dilated in MRCP or CT scan. All patients gained weight and presented normal physical and intelligence development. Conclusion Symptomatic PD associated with RAP can be completely diagnosed with ERCP . ESCS and Bi?ESCS are safe and effective endoscopic treatment techniques for pediatric cases.