小儿急性复发性和慢性胰腺炎的治疗性内镜逆行胰胆管造影术：来自INSPPIRE（国际小儿胰腺炎研究组：寻找治愈方法）研究的数据。
Therapeutic Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients With Acute Recurrent and Chronic Pancreatitis: Data From the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) Study.
作者信息
Troendle David M, Fishman Douglas S, Barth Bradley A, Giefer Matthew J, Lin Tom K, Liu Quin Y, Abu-El-Haija Maisam, Bellin Melena D, Durie Peter R, Freedman Steven D, Gariepy Cheryl, Gonska Tanja, Heyman Melvin B, Himes Ryan, Husain Sohail Z, Kumar Soma, Lowe Mark E, Morinville Veronique D, Ooi Chee Y, Palermo Joseph, Pohl John F, Schwarzenberg Sarah Jane, Werlin Steven, Wilschanski Michael, Zimmerman M Bridget, Uc Aliye
机构信息
From the *Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX; and †Section of Pediatric Gastroenterology and Nutrition, Baylor College of Medicine, Houston, TX; ‡Department of Pediatrics, Seattle Children's Hospital, Seattle, WA; §Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; ∥Department of Medicine and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA; ¶Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN; #Department of Paediatrics, University of Toronto, and Research Institute, The Hospital for Sick Children, Toronto, Canada; **Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; ††Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH; ‡‡Department of Pediatrics, University of California at San Francisco, San Francisco, CA; §§Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA; ∥∥Department of Pediatrics, Rady Children's Hospital, San Diego, CA; ¶¶Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada; ##Faculty of Medicine, School of Women's and Children's Health, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia; ***Division of Pediatric Gastroenterology, University of Utah, Salt Lake City, UT; †††Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI; ‡‡‡Department of Pediatric Gastroenterology, Hadassah Hebrew University Hospital, Jerusalem, Israel; and §§§Department of Biostatistics, University of Iowa College of Public Health; and ∥∥∥Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA.
出版信息
Pancreas. 2017 Jul;46(6):764-769. doi: 10.1097/MPA.0000000000000848.
OBJECTIVE
The aim of this study was to characterize utilization and benefit of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP).
METHODS
From August 2012 to February 2015, 301 children with ARP or CP were enrolled in the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) study. Physicians reported utilization and benefit of therapeutic ERCP at enrollment. Differences were analyzed using appropriate statistical methods.
RESULTS
One hundred seventeen children (38.9%) underwent at least 1 therapeutic ERCP. The procedure was more commonly performed in children with CP compared with those with ARP (65.8% vs 13.5%, P < 0.0001). Utility of therapeutic ERCP was reported to be similar between ARP and CP (53% vs 56%, P = 0.81) and was found to be helpful for at least 1 indication in both groups (53/99 patients [53.5%]). Predictors for undergoing therapeutic ERCP were presence of obstructive factors in ARP and CP, Hispanic ethnicity, or white race in CP.
CONCLUSIONS
Therapeutic ERCP is frequently utilized in children with ARP or CP and may offer benefit in selected cases, specifically if ductal obstruction is present. Longitudinal studies are needed to clarify the efficacy of therapeutic ERCP and to explore subgroups that might have increased benefit from such intervention.
目的
本研究旨在描述治疗性内镜逆行胰胆管造影术（ERCP）在急性复发性胰腺炎（ARP）或慢性胰腺炎（CP）患儿中的应用情况及益处。
方法
2012年8月至2015年2月，301例ARP或CP患儿纳入INSPPIRE（国际小儿胰腺炎研究组：寻找治愈方法）研究。医生在患儿入组时报告治疗性ERCP的应用情况及益处。采用适当的统计方法分析差异。
结果
117例患儿（38.9%）接受了至少1次治疗性ERCP。与ARP患儿相比，CP患儿更常接受该手术（65.8%对13.5%，P<0.0001）。据报告，ARP和CP患儿治疗性ERCP的效用相似（53%对56%，P = 0.81），且在两组中对至少1项指征有帮助（53/99例患者[53.5%]）。接受治疗性ERCP的预测因素包括ARP和CP中存在梗阻因素、西班牙裔种族或CP中的白种人。
结论
治疗性ERCP在ARP或CP患儿中经常使用，在某些特定情况下可能有益，特别是存在导管梗阻时。需要进行纵向研究以阐明治疗性ERCP的疗效，并探索可能从这种干预中获益更多的亚组。
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