ArticleBMC pediatrics2026
Risk factors for post-ERCP pancreatitis and assessment of stent exchange intervals in children with chronic pancreatitis: a single-center retrospective study.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundERPD serves as the first-line endoscopic interventional therapy for pediatric chronic pancreatitis (CP). However, pediatric-specific risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and the optimal stent exchange intervals remain poorly defined.
methodsIn this single-center retrospective study, pediatric CP patients (≤ 14 years) undergoing ERPD procedures (2015-2024) were enrolled. PEP was diagnosed per ESGE 2020 criteria (new/worsened abdominal pain + amylase/lipase > 3×ULN). Univariate and multivariate logistic regression identified PEP risk factors. Stent exchange intervals (standard interval vs. long interval) were compared for symptoms and acute pancreatitis occurrence.
resultsA cohort of 51 pediatric CP patients underwent 131 successful ERPD procedures. PEP occurred in 23 procedures (17.6%), all classified as mild and managed conservatively without severe complications. Univariate analysis revealed potential associations between PEP and several variables and multivariate analysis identified that pancreaticobiliary maljunction (PBM) (Adjusted OR = 4.861, 95% CI: 1.143-20.716, P = 0.032) and small stent diameter (≤ 5 Fr) (Adjusted OR = 3.083, 95% CI: 1.163-9.495, P = 0.047) were associated with increased PEP risk. No significant differences were observed in interval symptoms (standard interval: 22.7% vs. long interval: 27.6%, P = 0.693) or acute pancreatitis episodes (9.1% vs. 10.3%, P = 0.881) between the two groups.
conclusionsPBM and small stent diameter (≤ 5 Fr) are associated with increased PEP risk, although causality cannot be established. Extending stent exchange intervals beyond 6 months does not increase the risk of symptoms or acute pancreatitis. Individualizing stent replacement schedules to lower procedural burden appears feasible, which requires further validation in prospective studies.
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