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Pancreas. 2017 Jul;46(6):764-769. doi: 10.1097/MPA.0000000000000848.

Therapeutic Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients With Acute Recurrent and Chronic Pancreatitis: Data From the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) Study.

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From the *Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX; and †Section of Pediatric Gastroenterology and Nutrition, Baylor College of Medicine, Houston, TX; ‡Department of Pediatrics, Seattle Children's Hospital, Seattle, WA; §Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; ∥Department of Medicine and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA; ¶Department of Pediatrics, University of Minnesota, University of Minnesota Masonic Children's Hospital, Minneapolis, MN; #Department of Paediatrics, University of Toronto, and Research Institute, The Hospital for Sick Children, Toronto, Canada; **Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; ††Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH; ‡‡Department of Pediatrics, University of California at San Francisco, San Francisco, CA; §§Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA; ∥∥Department of Pediatrics, Rady Children's Hospital, San Diego, CA; ¶¶Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Canada; ##Faculty of Medicine, School of Women's and Children's Health, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia; ***Division of Pediatric Gastroenterology, University of Utah, Salt Lake City, UT; †††Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI; ‡‡‡Department of Pediatric Gastroenterology, Hadassah Hebrew University Hospital, Jerusalem, Israel; and §§§Department of Biostatistics, University of Iowa College of Public Health; and ∥∥∥Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA.



The aim of this study was to characterize utilization and benefit of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP).


From August 2012 to February 2015, 301 children with ARP or CP were enrolled in the INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) study. Physicians reported utilization and benefit of therapeutic ERCP at enrollment. Differences were analyzed using appropriate statistical methods.


One hundred seventeen children (38.9%) underwent at least 1 therapeutic ERCP. The procedure was more commonly performed in children with CP compared with those with ARP (65.8% vs 13.5%, P < 0.0001). Utility of therapeutic ERCP was reported to be similar between ARP and CP (53% vs 56%, P = 0.81) and was found to be helpful for at least 1 indication in both groups (53/99 patients [53.5%]). Predictors for undergoing therapeutic ERCP were presence of obstructive factors in ARP and CP, Hispanic ethnicity, or white race in CP.


Therapeutic ERCP is frequently utilized in children with ARP or CP and may offer benefit in selected cases, specifically if ductal obstruction is present. Longitudinal studies are needed to clarify the efficacy of therapeutic ERCP and to explore subgroups that might have increased benefit from such intervention.

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