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ABSTRACTS: Poster Session Abstracts

P0819 ENDOSCOPIC TREATMENT OF HEREDITARY CHRONIC PANCREATITIS IN YOUNG CHILDREN

Grandval, P.1; Sarles, J.2; Laugier, R.1

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Journal of Pediatric Gastroenterology and Nutrition: June 2004 - Volume 39 - Issue - p S368
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Introduction: Hereditary chronic pancreatitis is closely related to the R122H mutation of the cationic trypsinogen and is mainly characterized by an early onset, and acute pancreatitis consecutive to duct obstruction. Surgery is often proposed when medical therapeutics have failed. However, no studies has so far published results concerning the endoscopic management of hereditary pancreatitis.

Methods: We report on three cases of severe hereditary chronic pancreatitis related to the R122H mutation, which have been treated endoscopically. The first two cases were 8 and 10 y.o. and were suffering since the age of 4. The third case was a 20 month-old child with a cephalic cyst.

Results: Cases 1 and 2 were managed with pancreatic sphincterotomy, stone extraction, and endoprosthesis. Case 3 was treated using sphincterotomy and transpapillary cyst duodenostomy. All procedures allowed dramatic and durable improvement of pain. The first case relapsed six years after the beginning of the endoscopic therapy because of recurrence of stones and was successfully treated by pancreaticojejunostomy. No relapse was observed for the two other cases up to date (12 and 18 months respectively). One complication occurred in case 2 as a minor cholecystitis successfully treated by antibiotics.

Conclusion: Similar endoscopic techniques as those used in adults for chronic pancreatitis are safe and feasible even in young children suffering from hereditary chronic pancreatitis. These methods may lead to pain relief, and also allow to delay surgery if this later can not be avoided.

© 2004 Lippincott Williams & Wilkins, Inc.