Temporal Trend and Factors Associated with Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in Children in the USA: a Nationwide, Retrospective Cohort Study

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2023 Mar 5

PMID 36872379

Authors

Ronghui Zhu

Shengyong Wu

Jinfang Xu

Rui Wang

Yi Cheng

Yetao Xu

Chenxin Chen

Cheng Wu

Affiliations

Soon will be listed here.

Abstract

Conclusion: This study shows a decreasing national trend over time and identifies multiple protective and risk factors for pediatric PEP. Endoscopists can use the insights from this study to evaluate relevant factors before performing ERCP in children to prevent PEP and reduce the medical-care burden.

What Is Known: • Although ERCP has become indispensable procedure in children as they are in adults, education and training programs for ERCP in children are underdeveloped in many countries. • PEP is the most common and most serious adverse event following ERCP. Research on PEP in adults showed rising hospital admission and mortality rates associated with PEP in the USA.

What Is New: • The national temporal trend of PEP among pediatric patients in the USA was decreasing from 2008 to 2017. • Older age was a protective factor for PEP in children, while end-stage renal disease and stent insertion into the bile duct were risk factors.

References

Cotton P . Fifty years of ERCP: a personal review. Gastrointest Endosc. 2018; 88(2):393-396. DOI: 10.1016/j.gie.2018.04.013. View

Waye J . Endoscopic retrograde cholangiopancreatography in the infant. Am J Gastroenterol. 1976; 65(5):461-3. View

Mercier C, Pioche M, Albuisson E, Ponchon T, Gonzalez J, Barthet M . Safety of endoscopic retrograde cholangiopancreatography in the pediatric population: a multicenter study. Endoscopy. 2020; 53(6):586-594. DOI: 10.1055/a-1209-0155. View

Goetz M, Andersen P, Bergman J, Frei N, Schmidt A, Kahler G . ERCP in babies: Low risk of post-ERCP pancreatitis - results from a multicentre survey. United European Gastroenterol J. 2020; 8(1):77-80. PMC: 7006005. DOI: 10.1177/2050640619874187. View

Troendle D, Abraham O, Huang R, Barth B . Factors associated with post-ERCP pancreatitis and the effect of pancreatic duct stenting in a pediatric population. Gastrointest Endosc. 2015; 81(6):1408-16. DOI: 10.1016/j.gie.2014.11.022. View

Giefer M, Kozarek R . Technical outcomes and complications of pediatric ERCP. Surg Endosc. 2015; 29(12):3543-50. DOI: 10.1007/s00464-015-4105-1. View

Iqbal C, Baron T, Moir C, Ishitani M . Post-ERCP pancreatitis in pediatric patients. J Pediatr Gastroenterol Nutr. 2009; 49(4):430-4. DOI: 10.1097/01.mpg.0000361657.54810.19. View

Cheng C, Fogel E, Sherman S, McHenry L, Watkins J, Croffie J . Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography in children: a large series report. J Pediatr Gastroenterol Nutr. 2005; 41(4):445-53. DOI: 10.1097/01.mpg.0000177311.81071.13. View

Felux J, Sturm E, Busch A, Zerabruck E, Graepler F, Stuker D . ERCP in infants, children and adolescents is feasible and safe: results from a tertiary care center. United European Gastroenterol J. 2017; 5(7):1024-1029. PMC: 5676540. DOI: 10.1177/2050640616687868. View

10.

Deng Z, Zeng J, Lv C, Jiang L, Ji J, Li X . Prevalence and Factors Associated with Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Children. Dig Dis Sci. 2020; 66(1):224-230. DOI: 10.1007/s10620-020-06179-5. View

11.

Inamdar S, Slattery E, Bhalla R, Sejpal D, Trindade A . Comparison of Adverse Events for Endoscopic vs Percutaneous Biliary Drainage in the Treatment of Malignant Biliary Tract Obstruction in an Inpatient National Cohort. JAMA Oncol. 2015; 2(1):112-7. DOI: 10.1001/jamaoncol.2015.3670. View

12.

Wandling M, Hungness E, Pavey E, Stulberg J, Schwab B, Yang A . Nationwide Assessment of Trends in Choledocholithiasis Management in the United States From 1998 to 2013. JAMA Surg. 2016; 151(12):1125-1130. DOI: 10.1001/jamasurg.2016.2059. View

13.

Yadav D, OConnell M, Papachristou G . Natural history following the first attack of acute pancreatitis. Am J Gastroenterol. 2012; 107(7):1096-103. DOI: 10.1038/ajg.2012.126. View

14.

Inamdar S, Berzin T, Sejpal D, Pleskow D, Chuttani R, Sawhney M . Pregnancy is a Risk Factor for Pancreatitis After Endoscopic Retrograde Cholangiopancreatography in a National Cohort Study. Clin Gastroenterol Hepatol. 2015; 14(1):107-14. DOI: 10.1016/j.cgh.2015.04.175. View

15.

Mutneja H, Vohra I, Go A, Bhurwal A, Katiyar V, Palomera Tejeda E . Temporal trends and mortality of post-ERCP pancreatitis in the United States: a nationwide analysis. Endoscopy. 2020; 53(4):357-366. DOI: 10.1055/a-1220-2242. View

16.

Peduzzi P, Concato J, Kemper E, Holford T, Feinstein A . A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996; 49(12):1373-9. DOI: 10.1016/s0895-4356(96)00236-3. View

17.

Freeman M, DiSario J, Nelson D, Fennerty M, Lee J, Bjorkman D . Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001; 54(4):425-34. DOI: 10.1067/mge.2001.117550. View

18.

Freeman M, Guda N . Prevention of post-ERCP pancreatitis: a comprehensive review. Gastrointest Endosc. 2004; 59(7):845-64. DOI: 10.1016/s0016-5107(04)00353-0. View

19.

George S, Kulkarni A, Stevens G, Forsmark C, Draganov P . Role of osmolality of contrast media in the development of post-ERCP pancreatitis: a metanalysis. Dig Dis Sci. 2004; 49(3):503-8. DOI: 10.1023/b:ddas.0000020511.98230.20. View

20.

Limketkai B, Chandrasekhara V, Kalloo A, Okolo 3rd P . Comparison of performance and safety of endoscopic retrograde cholangiopancreatography across pediatric age groups. Dig Dis Sci. 2013; 58(9):2653-60. DOI: 10.1007/s10620-013-2691-0. View