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Post-ERCP Pancreatitis in Pediatric Patients

Iqbal, Corey W*; Baron, Todd H; Moir, Christopher R; Ishitani, Michael B

Journal of Pediatric Gastroenterology & Nutrition: October 2009 - Volume 49 - Issue 4 - p 430–434
doi: 10.1097/01.mpg.0000361657.54810.19
Original Articles: Gastroenterology

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, USA

Department of Gastroenterology & Hepatology, USA

Division of Pediatric Surgery, Mayo Clinic, Rochester, MN, USA

Received 10 March, 2008

Accepted 10 July, 2008

Address correspondence and reprint request to Todd H. Baron, MD, Department of Gastroenterology, 200 1st Street SW, Rochester, MN 55905 (e-mail: Baron.todd@mayo.edu).

The authors report no conflicts of interest.

© 2009 Lippincott Williams & Wilkins, Inc.