Medline ® Abstract for Reference 33
of 'ERCP in children: Technique, success and complications'
Post-ERCP pancreatitis in pediatric patients.
Iqbal CW, Baron TH, Moir CR, Ishitani MB
J Pediatr Gastroenterol Nutr. 2009;49(4):430.
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.
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.