Post-ERCP pancreatitis in pediatric patients

J Pediatr Gastroenterol Nutr. 2009 Oct;49(4):430-4. doi: 10.1097/01.mpg.0000361657.54810.19.

Abstract

Objectives: Pancreatitis is a known complication of endoscopic retrograde cholangiopancreatography (ERCP). Our aim was to assess the prevalence and severity of ERCP-associated pancreatitis using established criteria.

Materials and methods: Retrospective review of patients younger than 18 years undergoing ERCP complicated by post-ERCP pancreatitis defined by the 1991 consensus statement. Patients with chronic pancreatitis were studied separately using modified criteria. Risk factors for post-ERCP pancreatitis were analyzed.

Results: Three hundred forty-three ERCPs were performed in 224 patients. Two hundred seventy-six ERCPs were performed in patients without chronic pancreatitis, 7 of which were complicated by post-ERCP pancreatitis (prevalence 2.5%). Patients undergoing diagnostic-only ERCP were less likely to develop post-ERCP pancreatitis (P<0.01). Sixty-seven procedures were performed on patients with chronic pancreatitis; 10 developed postprocedure pain requiring or prolonging hospitalization (prevalence 14.9%). Pancreatic duct stenting was a risk factor for post-ERCP pain in this subset of patients (P=0.02).

Conclusions: The prevalence of post-ERCP pancreatitis is low-2.5% excluding patients with chronic pancreatitis and 4.96% overall. Therapeutic procedures and the presence of chronic pancreatitis are risk factors for post-ERCP pancreatitis.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
  • Cholangiopancreatography, Endoscopic Retrograde / classification
  • Humans
  • Pain / etiology
  • Pancreatic Ducts / surgery
  • Pancreatitis / etiology*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Stents