Wang Xue-Qi, Kong Chi-Huan, Ye Mao, Diao Mei
Department of General Surgery, Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China.
World J Gastrointest Surg. 2024 Dec 27;16(12):3754-3763. doi: 10.4240/wjgs.v16.i12.3754.
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.
To analyze the efficacy and safety of ERCP for the treatment of pediatric pancreatobiliary diseases.
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 ( = 52, treated with ERCP) and a control group ( = 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.
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 ( < 0.05), shorter times to resume eating, shorter hospital stays ( < 0.05), and significantly improved postoperative liver function ( < 0.05). CRP and serum amylase levels were significantly increased in both groups at 6 and 24 hours postoperatively ( < 0.05), but were significantly lower in the observation group ( < 0.05). The observation group also had a lower incidence of complications ( < 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 ( < 0.05).
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.
传统外科手术对于患有胰腺和胆道疾病的儿童具有高度侵入性且风险较大。内镜逆行胰胆管造影术(ERCP)主要应用于成人,因为它是一种安全有效的手术方法。其在儿童中的应用将有助于胰腺和胆道疾病患儿的治疗及预后。
分析ERCP治疗小儿胰胆疾病的有效性和安全性。
采用回顾性研究,使用2022年4月至2024年4月在首都儿科研究所附属儿童医院接受胰胆疾病治疗的101例儿科患者的病历。将患者分为观察组(n = 52,接受ERCP治疗)和对照组(n = 49,接受传统手术方法治疗)。对ERCP的诊断和治疗结果进行统计学分析。比较两组的治疗效果、恢复进食时间和住院时间。术前及术后1周监测肝功能指标。术前及术后6小时和24小时评估C反应蛋白(CRP)和血清淀粉酶水平的动态变化。还比较术后并发症。采用Logistic多因素回归分析ERCP对结局的独立影响。
观察组中,分别有36例和16例患者被诊断为胆道疾病和胰腺疾病。与对照组相比,观察组总体有效率更高(P < 0.05),恢复进食时间更短,住院时间更短(P < 0.05),术后肝功能显著改善(P < 0.05)。两组术后6小时和24小时CRP和血清淀粉酶水平均显著升高(P < 0.05),但观察组显著更低(P < 0.05)。观察组并发症发生率也更低(P < 0.05)。ERCP是影响小儿胰胆疾病治疗效果、住院时间、总胆红素、天冬氨酸转氨酶、丙氨酸转氨酶、CRP、血清淀粉酶及并发症发生的独立因素(P < 0.05)。
ERCP有效提高小儿胰胆疾病的治疗效果,炎症反应减轻,术后恢复更快,并发症更少。ERCP是小儿胰胆疾病安全有效的诊断和治疗方法。