Efficacy of early endoscopic intervention in pediatric pancreatic duct injury management.

Abstract

The optimal management method for pediatric pancreatic trauma is controversial. Moreover, the efficacy of stent placement via endoscopic retrograde pancreatography (ERP) remains poorly documented. The present, retrospective review of pediatric patients with pancreatic trauma was conducted from 2010 to 2020 at a single institution. Ten, male children with the median age of 9.5years (range 4-14years) with a grade I (n = 2), II (n = 4) or III (n = 4) pancreatic injury were identified. Of six of these patients in whom ERP was performed, four had a pancreatic duct injury (PDI). Pancreatic stent placement was performed in all the patients with ERP at a site proximal to the injury in four patients and across the injury in two patients. A pseudocyst or pancreatic fluid collection was detected in five patients, of these, two with a grade II injury were managed successfully with conservative therapy while three with PDI required surgery. In the four patients with PDI, only one in whom the stent was placed across the PDI was able to avoid surgery. Therapeutic ERP might be effective even if a patient has a PDI, therefore, early ERP should be considered as a treatment option.