Efficacy and safety of endoscopic retrograde cholangiopancreatography for pediatric patients with asparaginase-associated pancreatitis
10.3760/cma.j.cn321463-20250321-00492
- VernacularTitle:内镜逆行胰胆管造影术治疗儿童门冬酰胺酶相关胰腺炎的有效性及安全性
- Author:
Long LIN
1
;
Kaihua YANG
1
;
Zhaohui DENG
1
Author Information
1. 上海交通大学医学院附属上海儿童医学中心消化科，上海 200127
- Publication Type:Journal Article
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Asparaginase-associated pancreatitis;
Children;
Complications
- From:
Chinese Journal of Digestive Endoscopy
2025;42(11):892-897
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To preliminarily investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for recurrent acute pancreatitis and refractory pancreatic pseudocysts following asparaginase-associated pancreatitis (AAP) in children.Methods:A retrospective analysis was conducted on the clinical data of 19 pediatric patients who underwent ERCP for recurrent aute pancreatitis and refractory pancreatic pseudocysts following AAP at Shanghai Children's Medical Center between November 2018 and July 2024. Data primarily included ERCP procedure outcomes, ERCP-related complications. Pseudocyst size, frequency of pancreatitis episodes, and body mass index (BMI) before and after the ERCP intervention were compared.Results:A total of 30 ERCP procedures were performed in 19 children, with a technical success rate of 96.7% (29/30). Among the 13 children with recurrent acute pancreatitis, 11 remained symptom-free post-ERCP. One clild experienced 3 further episodes of acute mild pancreatitis following asparaginase administration, though the severity and duration of abdominal pain were reduced compared with pre-ERCP episodes. Another child developed 1 episode of aute mild pancreatitis after overeating. Both of them were resolved following medical treatment. Of the 12 children with pancreatic pseudocysts, complete resolution was observed in 8 cases, and significant reduction in size was achieved in 4 cases. All patients showed an increase in BMI postoperatively. A total of 10 procedure-related adverse events occurred, includings 5 post-ERCP pancreatitis (PEP), 5 postoperative infection, 2 hyperamylasemia, and 1 postoperative bleeding. Co-occurrence of PEP and infection was noted in 2 procedures, and PEP with bleeding in 1 procedure. All complications were managed successfully with conservative treatment.Conclusion:ERCP demonstrates favorable efficacy and acceptable safety for managing recurrent acute pancreatitis and refractory pancreatic pseudocysts following AAP in children.
