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Therapeutic Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients With Acute Recurrent and Chronic Pancreatitis: Data From the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) Study.

  • Author(s): Troendle, David M;
  • Fishman, Douglas S;
  • Barth, Bradley A;
  • Giefer, Matthew J;
  • Lin, Tom K;
  • Liu, Quin Y;
  • Abu-El-Haija, Maisam;
  • Bellin, Melena D;
  • Durie, Peter R;
  • Freedman, Steven D;
  • Gariepy, Cheryl;
  • Gonska, Tanja;
  • Heyman, Melvin B;
  • Himes, Ryan;
  • Husain, Sohail Z;
  • Kumar, Soma;
  • Lowe, Mark E;
  • Morinville, Veronique D;
  • Ooi, Chee Y;
  • Palermo, Joseph;
  • Pohl, John F;
  • Schwarzenberg, Sarah Jane;
  • Werlin, Steven;
  • Wilschanski, Michael;
  • Zimmerman, M Bridget;
  • Uc, Aliye
  • et al.
Abstract

Objective

The aim of this study was to characterize utilization and benefit of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP).

Methods

From August 2012 to February 2015, 301 children with ARP or CP were enrolled in the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) study. Physicians reported utilization and benefit of therapeutic ERCP at enrollment. Differences were analyzed using appropriate statistical methods.

Results

One hundred seventeen children (38.9%) underwent at least 1 therapeutic ERCP. The procedure was more commonly performed in children with CP compared with those with ARP (65.8% vs 13.5%, P < 0.0001). Utility of therapeutic ERCP was reported to be similar between ARP and CP (53% vs 56%, P = 0.81) and was found to be helpful for at least 1 indication in both groups (53/99 patients [53.5%]). Predictors for undergoing therapeutic ERCP were presence of obstructive factors in ARP and CP, Hispanic ethnicity, or white race in CP.

Conclusions

Therapeutic ERCP is frequently utilized in children with ARP or CP and may offer benefit in selected cases, specifically if ductal obstruction is present. Longitudinal studies are needed to clarify the efficacy of therapeutic ERCP and to explore subgroups that might have increased benefit from such intervention.

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