Application Of Therapeutic ERCP In Children With Pancreatic Diseases And Evaluation Of Efficacy Within 5 Years

Objective:AIM:The therapeutic effect of therapeutic endoscopic retrograde cholangiopancreatography(ERCP)in 24 cases of children with pancreatic disease was reviewed in order to explore the value of ERCP in the treatment of children's pancreatic diseases.Methods:From 2014 to 2018,24 children were treated with ERCP,ranging in age from 2 to 11 years.After the operation,fasting 24 H was taken to observe the symptoms and abdominal signs.3H,12 H,24H blood amylase and postoperative 24 H blood routine were examined to determine whether there were complications such as hyperamylase,pancreatitis,gastrointestinal bleeding and perforation after ERCP.Post-treatment follow-up included abdominal pain,diet,growth and development and follow-up treatment.Result:ERCP 32 was performed in 24 children,including biliary pancreatitis in 15 cases,pancreatic injury in 6 cases(grade ? in 6 cases),chronic pancreatitis in 3 cases,and biliary pancreatitis in 15 cases,pancreatic injury in 6 cases and chronic pancreatitis in 3 cases.All patients were successfully treated with ERCP.The symptoms of abdominal pain were improved in 15 children with biliary pancreatitis.There was no significant improvement in 6 children with pancreatic injury after Endoscopic nosal pancreas drainage or stent implantation in 6 children with pancreatic trauma.Follow-up ERCP treatment found pancreatic pseudocyst in 3cases and pancreatic fistula in 3 cases.All 3 cases with chronic pancreatitis were complicated with pancreatic duct stones and pancreatic duct stricture,and 2 cases showed segmental dilation of pancreatic duct.Post-ERCP pancreatitis shows in 3 cases,all of them were mild,none of 24 children had serious complications such as gastrointestinal perforation,hemorrhage,death.Conclusion:Therapeutic ERCP is a minimally invasive,reliable,safe and effective method for the treatment of pancreatic diseases in children.However,the complete treatment of children with cholangiectasis and pancreatic trauma of more than 3degrees still needs to be combined with surgery.Objective:There are more and more applications of ERCP in children.Therefore,we analysis the follow-up results of children with pancreatic-related diseases treated with ERCP within 5 years in order to confirm the efficacy of ERCP in children with pancreatic diseases within 5 years.Methods:A total of 24 children,ranging from 2 to 11 years of age,were treated in our hospital from 2014.01 to 2018.02 in general surgery with abdominal pain,elevated serum amylase or urinary amylase,and followed-up of 24 children who were treated with ERCP and followed up until 2019.02.The complications,hepatobiliary and pancreatic function,diet,growth and development and follow-up treatment were observed.Result:ERCP 32 was performed in 24 children,including biliary pancreatitis in 15 cases,pancreatic injury in 6 cases(grade ? in 6 cases),chronic pancreatitis in 3 cases,and biliary pancreatitis in 15 cases,pancreatic injury in 6 cases and chronic pancreatitis in 3 cases.The follow-up period ranged from 12 months to 60 months.No significant abnormality was found in abdominal B-ultrasound and biochemical group.Among 13 children with choledochal cyst,9 received choledochectomy and hepatojejunal Roux-en-Y.There was no obvious discomfort after operation.The remaining 4 cases were followed up without obvious abdominal pain,stable condition and no malaise.6 cases of pancreatic duct trauma had no obvious discomfort symptoms,and the diet and defecation condition were similar to those of normal children.The follow-up abdominal B-ultrasound examination showed that there was no obvious abnormality of pancreatic tissue in children with pancreatic duct trauma.All the children with chronic pancreatitis could maintain asymptomatic life,and the growth and development of body height and weight of 2 children were slower than those of the same age children,and the growth and development of the remaining 22 children were the same as those of normal children.Conclusion:The most of children with pancreatic diseases and treated with ERCP,their growth,habits were not significantly different from normal children,those Children could maintain asymptomatic life.However,for children with severe choledochal dilatation,a complete improvement in the condition still needs to be combined with surgical treatment.