BACKGROUND: Chronic pancreatitis (CP) in children is an inreasingly recognized disease. OBJECTIVE: The purpose of study was to analyse the safety and long-term efficacy of endoscopic treatment in children with CP. METHODS: Records of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico "A. Gemelli" IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre- and post- endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated. RESULTS: In total 158 ERCPs were performed. Median post-ERCP follow-up was 7 years. The majority of patients had CP type IV (47%) and type Ib (37%) (Cremer's classification). Major papilla pancreatic sphincterotomy was performed in 47%, major and minor in 24% and minor in 29% of patients. Stones/plugs were removed in at least one ERCPs in 66% individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3%). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery. CONCLUSION: Endoscopic management of symptomatic CP in children is safe and effective.

Centre for Endoscopic Research Therapeutics and Training CERTT Università Cattolica del Sacro Cuore Roma Italia

Chair of Digestive Endoscopy IHU USIAS University of Strasbourg Strasbourg France

Charles University Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove 2nd Department of Internal Medicine Gastroenterology Hradec Kralove Czech Republic

Department of Gastroenterology Yokohama City University Graduate School of Medicine Yokohama Japan

Department of Gastroenterology Yokohama Minami Kyosai Hospital Yokohama Japan

Digestive Endoscopy Unit Fondazione Policlinico Universitario A Gemelli IRCCS Roma Italia

The Royal Marsden NHS Foundation Trust London UK

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