Impact of ERCP on pancreatitis frequency in pediatric acute recurrent or chronic pancreatitis: An INSPPIRE‐2 study

OBJECTIVES: Treatment options for pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are limited. We aim to quantify the response rate to endoscopic retrograde cholangiopancreatography (ERCP) and identify predictive factors that determine response in children with ARP or CP. METHODS: Data was obtained from the INternational Study Group of Pediatric Pancreatitis: In search for a cu RE-2 cohort who underwent ERCP. ERCP response was defined as a decrease in acute pancreatitis (AP) attacks by 50% in the year after first ERCP, compared to the year before this ERCP. Fisher's exact test was used to assess associations between categorical variables and Wilcoxon rank-sum test or two-sample t-test for continuous variables. RESULTS: There were 436 children who underwent a total of 1504 ERCPs in our cohort. Eighty-five patients (19.5%) had ARP; 351 (80.5%) had CP. Significant differences were noted between those who had ERCP and those who did not based on sex, BMI percentile and diagnosis. ERCP response rate was 70.0% (n = 206). Patients with pancreatic duct calculi/obstruction were more likely to be ERCP responders (p < 0.04). CONCLUSIONS: ERCP was used commonly in the treatment of ARP/CP for children with any pancreatic duct abnormality. Two-thirds of children responded well to endoscopic therapy with at least 50% decrease in AP attacks the year post-initial ERCP; ductal calculi/obstruction were associated with higher rate of response. These results support that therapeutic ERCP is safe and may provide short to medium-term therapeutic benefit in children with ARP or CP especially with ductal factors seen on pre-intervention imaging.

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Publication Details

Journal
Journal of Pediatric Gastroenterology and Nutrition
Published
2026-10-26
DOI
https://doi.org/10.1002/jpn3.70635
Primary Topic
Pancreatitis Pathology and Treatment
Type
article
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article

Impact of ERCP on pancreatitis frequency in pediatric acute recurrent or chronic pancreatitis: An INSPPIRE‐2 study

Tanja Y. Gonska, Elissa M. Downs, Ankur A. Chugh, Emily Rothbaum Perito et al.
Journal of Pediatric Gastroenterology and Nutrition
Pancreatitis Pathology and Treatment
article

Impact of ERCP on pancreatitis frequency in pediatric acute recurrent or chronic pancreatitis: An INSPPIRE‐2 study

Tanja Y. Gonska, Elissa M. Downs, Ankur A. Chugh, Emily Rothbaum Perito, Michael P. Joseph, Douglas S. Lindblad, Amit S. Grover, Mark E. Lowe, Andrew Liman, Gretchen A. Cress, Véronique D. Morinville, Michael A. Wilschanski, Brian A. McFerron, Maisam A. Abu‐El‐Haija, Chee Yee Ooi, Aliye Uç, Matthew J. Giefer, Asim Maqbool, Jacob Mark, Alvin Jay Freeman, Reuven Zev Cohen, Yuhua Zheng, Megha S. Mehta, Douglas Shawn Fishman, Kenneth Ng, Fuchenchu Wang, Quin Y. Liu, Feng Tian, Robert Adam Noe, Ying Yuan
article en

Abstract

OBJECTIVES: Treatment options for pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are limited. We aim to quantify the response rate to endoscopic retrograde cholangiopancreatography (ERCP) and identify predictive factors that determine response in children with ARP or CP. METHODS: Data was obtained from the INternational Study Group of Pediatric Pancreatitis: In search for a cu RE-2 cohort who underwent ERCP. ERCP response was defined as a decrease in acute pancreatitis (AP) attacks by 50% in the year after first ERCP, compared to the year before this ERCP. Fisher's exact test was used to assess associations between categorical variables and Wilcoxon rank-sum test or two-sample t-test for continuous variables. RESULTS: There were 436 children who underwent a total of 1504 ERCPs in our cohort. Eighty-five patients (19.5%) had ARP; 351 (80.5%) had CP. Significant differences were noted between those who had ERCP and those who did not based on sex, BMI percentile and diagnosis. ERCP response rate was 70.0% (n = 206). Patients with pancreatic duct calculi/obstruction were more likely to be ERCP responders (p < 0.04). CONCLUSIONS: ERCP was used commonly in the treatment of ARP/CP for children with any pancreatic duct abnormality. Two-thirds of children responded well to endoscopic therapy with at least 50% decrease in AP attacks the year post-initial ERCP; ductal calculi/obstruction were associated with higher rate of response. These results support that therapeutic ERCP is safe and may provide short to medium-term therapeutic benefit in children with ARP or CP especially with ductal factors seen on pre-intervention imaging.

Journal of Pediatric Gastroenterology and Nutrition
Cedars-Sinai Medical Center (US), Cincinnati Children's Hospital Medical Center (US), Boston Children's Hospital (US), University of Minnesota (US), Nationwide Children's Hospital (US), Children's Hospital of Philadelphia (US), Children's Hospital of Los Angeles (US), The University of Texas MD Anderson Cancer Center (US), Harvard University (US), Johns Hopkins University (US), Emory University (US), University of California, San Francisco (US), Baylor College of Medicine (US), University of Toronto (CA), Medical College of Wisconsin (US), Washington University in St. Louis (US), Ochsner Medical Center (US), Hadassah Medical Center (IL), Montreal Children's Hospital (CA), Hospital for Sick Children (CA), Riley Hospital for Children (US), Children's Hospital Colorado (US), University of Iowa Stead Family Children’s Hospital (US), Stanford Health Care (US), Children's Health Council (US), Sydney Children's Hospital (AU), Johns Hopkins Children's Center (US), Children's Hospital of Pittsburgh (US), Children's Healthcare of Atlanta (US), Texas Children's Hospital (US), Sickkids Research Institute (CA), McGill University (CA), University of Colorado Anschutz Medical Campus (US), The Ohio State University (US), Indiana University – Purdue University Indianapolis (US), University of Cincinnati (US), The University of Texas Southwestern Medical Center (US)
Openalex Percentile: Top 9%
Pancreatitis Pathology and Treatment
DOISourceOpenAlex
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