Therapeutic step-up strategy for management of hereditary pancreatitis in children
| Autor: | W. Pumberger, Rainer Schöfl, H.C. Duba, M Kienbauer, S Kargl |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Cholangiopancreatography Magnetic Resonance Diagnosis Differential Pancreatitis Chronic medicine Humans Genetic Testing Child Genetic testing Cholangiopancreatography Endoscopic Retrograde Magnetic resonance cholangiopancreatography Hereditary pancreatitis Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Everyday activities General surgery Disease Management General Medicine medicine.disease Surgery Treatment Outcome Obstructive pancreatitis Child Preschool Practice Guidelines as Topic Pediatrics Perinatology and Child Health Etiology Pancreatitis Female business |
| Zdroj: | Journal of Pediatric Surgery. 50:511-514 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2014.05.016 |
| Popis: | Background/Purpose Various different regimes exist for the treatment of hereditary pancreatitis in childhood. Here, we propose a therapeutic pathway with emphasis on endoscopic and surgical procedures. Methods From 2006 to 2013, 12 patients with a diagnosis of hereditary pancreatitis were prospectively included in a therapeutic step-up schema. The treatment outcome was evaluated and correlated to aetiological factors and pathoanatomic findings. Results After diagnostic work-up (laboratory data, ultrasound examination, magnetic resonance cholangiopancreatography and genetic testing), all 12 patients underwent early endoscopic retrograde cholangiopancreatography (ERCP), which was successfully performed in ten children. Obstructive pancreatitis was found in eight children, and required sphincterotomy, dilation and stenting for 12months. In two children with unsuccessful ERCP, open surgical drainage procedures were performed. After a mean follow-up of 32months all children are free of recurrence of pancreatitis without any impairment of everyday activities. Conclusions For children with hereditary pancreatitis, a therapeutic step plan with early ERCP and open surgical drainage procedures in case of impossible or insufficient endoscopic treatment prevents recurring pancreatitis and offers a normal quality of life without any major complications. |
| Databáze: | OpenAIRE |
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