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Abstract

We appreciate Dr Oracz's interest and for bringing these articles to our attention. We performed a comprehensive literature search of MEDLINE/PubMed, Ovid Embase, and Web of Science, which yielded 1642 unique articles. From this result, articles were screened and assessed for eligibility. Additionally, citations for included articles were hand searched to identify additionally resources. The article by Oracz et al1Oracz G. Pertkiewicz J. Kierkus J. Dadalski M. Socha J. Ryzko J. Efficiency of pancreatic duct stenting therapy in children with chronic pancreatitis.Gastrointest Endosc. 2014; 80: 1022-1029Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar was identified during our comprehensive literature search. However, during our screening process the article was excluded given that the time period extended from 1988 to 2012. We had previously established criteria to exclude studies reporting on procedures performed before 1995 to avoid overlap with a previously published meta-analysis by Fox et al.2Fox V.L. Werlin S.L. Heyman M.B. Endoscopic retrograde cholangiopancreatography in children. Subcommittee on Endoscopy and Procedures of the Patient Care Committee of the North American Society for Pediatric Gastroenterology and Nutrition.J Pediatr Gastroenterol Nutr. 2000; 30: 335-342Crossref PubMed Scopus (58) Google Scholar The report by Wejnarska et al3Wejnarska K. Kolodziejczyk E. Wertheim-Tysarowska K. Dadalski M. Sobczynska-Tomaszewska A. Kierkus J. et al.The etiology and clinical course of chronic pancreatitis in children with early onset of the disease.J Pediatr Gastroenterol Nutr. 2016; 63: 665-670Crossref PubMed Scopus (16) Google Scholar was not identified by our search terms/criteria. This may have been because the title and abstract do not directly mention endoscopic retrograde cholangiopancreatography (ERCP) or complications. The adverse event rate presented in Oracz et al was 1.9% (9 of 475 procedures), although this study does not seem to include post-ERCP pancreatitis as an adverse event.1Oracz G. Pertkiewicz J. Kierkus J. Dadalski M. Socha J. Ryzko J. Efficiency of pancreatic duct stenting therapy in children with chronic pancreatitis.Gastrointest Endosc. 2014; 80: 1022-1029Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar This rate is very similar to the pooled estimate of complications other than post-ERCP pancreatitis in our meta-analysis, which was 1% (95% CI 0%-3%). The study by Dr Oracz had more procedures than any individual study included in our analysis. Individual operator experience is clearly important in minimizing complications. Our review did include a diverse group of 32 international centers adding to the richness of our results. The addition of the study by Oracz et al would further enrich the heterogeneous group of providers, patients, and procedure settings, which provides additional credibility in determining the adverse event rate for ERCP. Complications of endoscopic retrograde cholangiopancreatography in children with chronic pancreatitis depends on center experienceThe Journal of PediatricsVol. 186PreviewWe read with interest the report by Usatin et al.1 Although experience with endoscopic retrograde cholangiopancreatography (ERCP) in children is growing, there is a lack of well-documented ERCP safety information in children with chronic pancreatitis.1-4 The authors reviewed most of the known studies concerning ERCP and its safety in children. However, the authors did not cite our recent study.3 We reviewed our database of children with chronic pancreatitis with particular attention to complication rate of ERCP. Full-Text PDF