期刊
JOURNAL OF DIGESTIVE DISEASES
卷 23, 期 11, 页码 651-659出版社
WILEY
DOI: 10.1111/1751-2980.13152
关键词
child; endoscopic retrograde cholangiopancreatography; magnetic resonance cholangiopancreatography; pancreaticobiliary malformation; pancreatitis
In this study, we retrospectively analyzed the clinical characteristics of 148 pediatric patients with pancreatitis and pancreaticobiliary malformation. We found that pancreaticobiliary malformation was associated with the development of pancreatitis. Patients with pancreaticobiliary maljunction were younger and more likely to have jaundice and fever compared to those with pancreatic divisum. Genetic mutations were found in a significant proportion of patients with pancreatic divisum and annular pancreas. MRCP had limited diagnostic value for identifying pancreaticobiliary malformation in children. ERCP was effective and safe for the diagnosis and treatment of pediatric pancreatitis caused by pancreaticobiliary malformation.
Objectives: We aimed to describe the clinical characteristics of pediatric patients with pancreatitis caused by pancreaticobiliary malformation and to evaluate the efficacy and safety of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of the disease.Methods: Medical records of pediatric patients with pancreatitis related to pancreaticobiliary malformation diagnosed by ERCP and treated in our hospital between April 2008 and December 2020 were retrospectively reviewed. Clinical manifestations, laboratory indicators, genetic testing results and imaging findings including MRCP were collected.Results: Of the 148 patients with pancreaticobiliary malformation-related pancreatitis, 90 (60.8%) had pancreaticobiliary maljunction (PBM), 52 (35.1%) had pancreatic divisum (PD), and six (4.1%) had annular pancreas (AnnP). Compared with the PD group, patients with PBM were younger (P < 0.001), and were more likely to have jaundice (P < 0.001) and fever (P = 0.034). Genetic mutation was found in 51.6% of patients with PD, 50.0% with AnnP, and 15.0% with PBM. Diagnostic rate of PBM, PD, and AnnP using MRCP was 46.7%, 15.4%, and 100%, respectively. In total, 87.8% of patients had symptomatic improvement after endoscopic treatment. ERCP-related complications were observed in 28 out of the 260 procedures, including post-ERCP pancreatitis (7.7%), infection (2.3%), and gastrointestinal bleeding (0.8%).Conclusions: PBM should be considered when jaundice and fever occur in pediatric patients. Genetic testing is recommended for those with PD and AnnP. The role of MRCP is limited in identifying pancreaticobiliary malformation in children. ERCP is effective and safe for the diagnosis and treatment for pediatric pancreatitis caused by pancreaticobiliary malformation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据