Clinical characteristics and endoscopic treatment of pancreatitis caused by pancreaticobiliary malformation in Chinese children.

AIM: To describe the clinical characteristics and imaging diagnoses and evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreatitis caused by pancreaticobiliary malformation.

METHODS: We retrospectively analyzed the clinical data of children with pancreatitis caused by pancreaticobiliary malformation between April 2008 and December 2020.

RESULTS: Of the 148 patients with pancreaticobiliary malformation, 90 (60.8%) had pancreaticobiliary maljunction (PBM), 52 (35.1%) had pancreatic divisum (PD), and six (4.1 %) had annular pancreas (AnnP). Patients in the PBM group were younger(p<0.001) and had more frequent jaundice(p<0.001) and fever(p=0.034) symptoms than those in the PD group. Genetic mutations were found in 51.6% of patients with PD, 50% with AnnP, and 15% with PBM. Diagnostic rates of magnetic resonance cholangiopancreatography (MRCP) for PBM, PD, and AnnP were 46.7%, 15.4%, and 100%, respectively. In total, 87.8% of patients had improved symptoms after endoscopic treatment. Procedure-related complications were observed in 28 procedures and included post-ERCP pancreatitis (20/260, 7.7%), infection (6/260, 2.3%), and gastrointestinal bleeding (2/260, 0.8%).

CONCLUSIONS: PBM should be considered when jaundice and fever occur. Genetic screening is recommended for pancreatitis in children with PD and AnnP. MRCP has limitations in identifying pancreaticobiliary malformation in children. ERCP is a safe and effective treatment option for pediatric pancreatitis caused by pancreaticobiliary malformation. This article is protected by copyright. All rights reserved.