Graham K S, Ingram J D, Steinberg S E, Narkewicz M R
Department of Pediatrics, University of Colorado School of Medicine, Denver, USA.
Gastrointest Endosc. 1998 Jun;47(6):492-5. doi: 10.1016/s0016-5107(98)70250-0.
Although ERCP is commonly performed in children, the effect of findings at ERCP on the subsequent management of pediatric pancreatitis is unknown.
We retrospectively reviewed charts to determine the impact of ERCP on the management of recurrent acute or chronic pancreatitis in 17 consecutive children (3 boys and 14 girls, 3 to 16 years, mean 11.2 years) with recurrent acute (n = 13) or chronic pancreatitis (n = 4) who underwent ERCP. Radiographs were reviewed in a blinded manner, and the effect of ERCP findings on subsequent management was determined.
In 16 of 17 patients (94%), the pancreatic duct was successfully visualized. Of the 16 studies, 9 (56%) had abnormal findings. A change in therapy occurred in all 9 patients as a result of the findings at ERCP. Of the 7 patients with a prior abnormal CT or ultrasound, 5 (71%) had an abnormal ERCP, all resulting in a change in therapy. Three of the 9 patients (33%) without radiographic abnormalities had an abnormal ERCP that, in each case, resulted in a change in therapy. Overall, findings at ERCP altered therapy in 52% of pediatric patients studied with recurrent acute or chronic pancreatitis. A prior abnormal CT had a high predictive value with respect to ERCP resulting in a change in management (83%).
ERCP is useful in the management of pediatric recurrent acute or chronic pancreatitis; abnormalities are found at a rate similar to those found in adults.
尽管内镜逆行胰胆管造影术（ERCP）在儿童中普遍开展，但ERCP检查结果对小儿胰腺炎后续治疗的影响尚不清楚。
我们回顾性分析了连续17例接受ERCP检查的复发性急性或慢性胰腺炎患儿（3例男孩和14例女孩，年龄3至16岁，平均11.2岁）的病历，以确定ERCP对其治疗的影响。以盲法回顾X线片，并确定ERCP检查结果对后续治疗的影响。
17例患者中有16例（94%）胰管成功显影。在这16例检查中，9例（56%）有异常发现。由于ERCP检查结果，所有9例患者的治疗均发生了改变。在之前CT或超声检查异常的7例患者中，5例（71%）ERCP检查异常，均导致治疗改变。在9例无影像学异常的患者中，3例（33%）ERCP检查异常，每例均导致治疗改变。总体而言，在接受研究的复发性急性或慢性胰腺炎小儿患者中，52%的患者ERCP检查结果改变了治疗方案。之前CT检查异常对ERCP检查结果导致治疗方案改变具有较高的预测价值（83%）。
ERCP对小儿复发性急性或慢性胰腺炎的治疗有用；其异常发现率与成人相似。
