Wang XQ, Kong CH, Ye M, Diao M. Analysis of the efficacy and safety of endoscopic retrograde cholangiopancreatography for the treatment of pediatric pancreatobiliary diseases. World J Gastrointest Surg 2024; 16(12): 3754-3763 [DOI: 10.4240/wjgs.v16.i12.3754]
Corresponding Author of This Article
Mei Diao, PhD, Chief Physician, Department of General Surgery, Children's Hospital Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing 100020, China. diaomei3001@gmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3754-3763 Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3754
Analysis of the efficacy and safety of endoscopic retrograde cholangiopancreatography for the treatment of pediatric pancreatobiliary diseases
Xue-Qi Wang, Chi-Huan Kong, Mao Ye, Mei Diao
Xue-Qi Wang, Chi-Huan Kong, Mao Ye, Mei Diao, Department of General Surgery, Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China
Author contributions: Wang XQ designed the study; Wang XQ and Kong CH collected and analyzed the data; Wang XQ wrote the manuscript; Wang XQ and Ye M revised the manuscript; Wang XQ and Diao M participated in collection of the data; all authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Children's Hospital Capital Institute of Pediatrics.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei Diao, PhD, Chief Physician, Department of General Surgery, Children's Hospital Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing 100020, China. diaomei3001@gmail.com
Received: August 26, 2024 Revised: October 11, 2024 Accepted: October 18, 2024 Published online: December 27, 2024 Processing time: 93 Days and 1.7 Hours
Abstract
BACKGROUND
Traditional surgical procedures are highly invasive and risky for children with pancreatic and biliary diseases. Endoscopic retrograde cholangiopancreatography (ERCP) has been used mostly in adults because it is a safe and effective surgical procedure. Its application in children will contribute to the treatment and prognosis of children with pancreatic and biliary diseases.
AIM
To analyze the efficacy and safety of ERCP for the treatment of pediatric pancreatobiliary diseases.
METHODS
A retrospective study was performed using the medical records of 101 pediatric patients who received treatment for pancreatobiliary diseases at Children’s Hospital Capital Institute of Pediatrics from April 2022 to April 2024. The patients were divided into an observation group (n = 52, treated with ERCP) and a control group (n = 49, treated with traditional surgical methods). Diagnostic and therapeutic outcomes of ERCP were statistically analyzed. Treatment efficacy, time to resume eating, and hospital stay duration were compared between the two groups. Indicators of liver function were monitored preoperatively and one week postoperatively. Dynamic changes in C-reactive protein (CRP) and serum amylase levels were assessed preoperatively and at 6 and 24 hours postoperatively. Postoperative complications were also compared. Logistic multivariate regression was used to analyze the independent effect of ERCP on outcomes.
RESULTS
For the observation group, 36 and 16 patients were diagnosed with biliary and pancreatic diseases, respectively. Compared with the control group, the observation group exhibited a higher overall effective rate (P < 0.05), shorter times to resume eating, shorter hospital stays (P < 0.05), and significantly improved postoperative liver function (P < 0.05). CRP and serum amylase levels were significantly increased in both groups at 6 and 24 hours postoperatively (P < 0.05), but were significantly lower in the observation group (P < 0.05). The observation group also had a lower incidence of complications (P < 0.05). ERCP was an independent factor affecting treatment efficacy, length of hospital stay, total bilirubin, aspartate aminotransferase, and alanine aminotransferase, CRP, serum amylase, and the occurrence of complications in children with pancreaticobiliary diseases (P < 0.05).
CONCLUSION
ERCP effectively enhances the treatment efficacy of pediatric pancreatobiliary diseases, with a reduced inflammatory response, faster postoperative recovery, and fewer complications. ERCP is a safe and effective diagnostic and therapeutic method for pediatric pancreatobiliary diseases.
Core Tip: Pancreatic and biliary diseases are serious illnesses. Children with pancreatic and biliary diseases have traditionally received surgery; however, these procedures are traumatic and risky. Thus far, endoscopic retrograde pancreaticobiliary angiography has been used in adults as a safe and effective surgical procedure; however, there are few studies analyzing its efficacy in children. The purpose of this study was to evaluate the effect and safety of endoscopic retrograde pancreaticobiliary angiography for the treatment of pancreatic and biliary diseases in children.
