Guo Jing, Jia Qian-Ru, Sun Mei
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pediatr. 2021 Jun 10;9:677894. doi: 10.3389/fped.2021.677894. eCollection 2021.
To investigate the clinical profiles of children with pancreatitis caused by pancreaticobiliary malformation. We retrospectively analysed the clinical data of children diagnosed with pancreatitis at our institute from June 2017 to January 2021. A total of 195 patients and 169 control subjects were included in this study. Twenty-six (13.3%) patients had pancreaticobiliary malformation-related pancreatitis. The average age of onset in the pancreaticobiliary malformation pancreatitis (PMP) group was lower than that in the non-PMP group, and the difference was statistically significant. The number of patients in the PMP group that had jaundice was significantly higher than that of the non-PMP group ( < 0.05). Logistic regression analysis showed that total bilirubin (TB) and γ-glutamyltransferase (GGT) (odds ratio = 1.096, < 0.01) were independent predictors of pancreaticobiliary malformation-related pancreatitis in children. The positive detection rate of pancreaticobiliary malformation was 68% for abdominal ultrasound, 38.4% for abdominal enhanced computed tomography, and 91.3% for magnetic resonance cholangiopancreatography (MRCP). The recurrence rate (34.6%) in the PMP group was higher than that in the non-PMP group (15.4%, < 0.05); surgical therapy had the lowest recurrence rate. Age at initial onset of pancreatitis was younger and the period to recurrence was shorter in the PMP group than in the non-PMP group ( < 0.05). Pancreaticobiliary malformation is one of the major causes of paediatric pancreatitis. Elevated TB and GGT in patients with pancreatitis may be suggestive for underlying pancreaticobiliary malformation not solely to pancreatitis. MRCP should be used when pancreatitis due to pancreaticobiliary malformation is suspected. Surgery or endoscopic retrograde cholangiopancreatography-guided intervention may be helpful but further study is needed.
为研究胰胆畸形所致儿童胰腺炎的临床特征。我们回顾性分析了2017年6月至2021年1月在我院诊断为胰腺炎的儿童的临床资料。本研究共纳入195例患者和169例对照。26例(13.3%)患者患有胰胆畸形相关性胰腺炎。胰胆畸形性胰腺炎(PMP)组的平均发病年龄低于非PMP组,差异有统计学意义。PMP组出现黄疸的患者数量显著高于非PMP组(<0.05)。Logistic回归分析显示,总胆红素(TB)和γ-谷氨酰转移酶(GGT)(比值比=1.096,<0.01)是儿童胰胆畸形相关性胰腺炎的独立预测因素。腹部超声对胰胆畸形的阳性检出率为68%,腹部增强计算机断层扫描为38.4%,磁共振胰胆管造影(MRCP)为91.3%。PMP组的复发率(34.6%)高于非PMP组(15.4%,<0.05);手术治疗的复发率最低。PMP组胰腺炎初次发病的年龄比非PMP组年轻,复发时间也更短(<0.05)。胰胆畸形是儿童胰腺炎的主要病因之一。胰腺炎患者TB和GGT升高可能提示潜在的胰胆畸形,而非单纯的胰腺炎。怀疑胰胆畸形所致胰腺炎时应使用MRCP。手术或内镜逆行胰胆管造影引导下的干预可能有帮助,但还需要进一步研究。