The following is a summary of “Risk Factors for Post-ERCP Pancreatitis in Pediatric and Young Adult Patients,” published in the June 2023 issue of Pediatrics by Hassan, et al.
For a study, researchers sought to identify factors associated with the development of post-ERCP pancreatitis (PEP) in pediatric patients who underwent endoscopic retrograde cholangiopancreatography (ERCP). PEP is the most common complication of ERCP, and limited data exist on its occurrence in pediatric patients. They aimed to identify potential risk factors for PEP in this population.
The study involved a retrospective review of patients who underwent ERCP at a single institution between 2012 and 2020. Patient and procedure-related factors were collected and analyzed. Statistical tests, such as Chi-square or Fisher exact tests and Mann-Whitney-Wilcoxon tests, were used for data analysis.
A total of 736 ERCPs were performed in 402 unique patients. PEP occurred in 94 cases (12.8% of ERCPs), with 91 cases classified as mild and 3 as moderately severe. Factors associated with PEP included pancreatic indication for ERCP, native major papilla, successful cannulation and injection into the pancreatic duct (PD), and higher American Society for Gastrointestinal Endoscopy (ASGE) complexity scores. A higher proportion of PEP patients received rectal indomethacin (65% vs. 47%, P = 0.002) and had prophylactic (31% vs. 20%, P = 0.01) or therapeutic PD stent placement (37% vs. 27%, P = 0.04). However, these associations were not persistent in a subgroup analysis of high-risk patients. A smaller proportion of PEP patients had PRSS1 mutation than non-PEP patients (22% vs. 40%, P = 0.04).
The study identified factors associated with the development of PEP in a large cohort of pediatric patients who underwent ERCP. The observed high rate of PEP may be attributed to the higher rates of pancreatic indications and higher ASGE complexity scores in this cohort compared to previously reported literature. Randomized prospective trials are needed to further investigate the effectiveness of various interventions and better define their utility in preventing PEP in pediatric patients.
Source: journals.lww.com/jpgn/Abstract/2023/06000/Risk_Factors_for_Post_ERCP_Pancreatitis_in.21.aspx