Journal of Developmental Medicine(Electronic Version)  2023, Vol. 11 Issue (5): 364-370 DOI: 10.3969/j.issn.2095-5340.2023.05.007 |
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| Clinical study of endoscopic retrograde cholangiopancreatography for the treatment of pancreaticobiliary maljunction in children |
| Du Shuwen, Wang Jiheng, Jin Peng, et al
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(1. Department of Gastroenterology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China; 2. Department of Gastroenterology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China; 3. Department of Gastroenterology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China; 4. Beijing Key Laboratory of Pediatric Organ Failure, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Institute of Pediatrics,the Seventh Medical Center of Chinese PLA General Hospital, Faculty of Pediatrics, the Chinese PLAGeneral Hospital, Beijing 100700, China)
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Abstract 【Abstract】 Objective To investigate the clinical effect and prognosis of endoscopic retrograde
cholangiopancreatography (ERCP) in the treatment of pancreaticobiliary maljunction (PBM). Method Theclinical data of 60 PBM children admitted to the Seventh Medical Center of Chinese PLA General Hospitalfrom January 2014 to December 2020 were analyzed retrospectively, and they were divided into ERCP group(n=30) and surgical group (n=30) according to treatment methods. The clinical data, auxiliary examinationand prognosis of the children were analyzed. The statistical methods performed by Wilcoxon rank sum test,Mann-Whitney test, χ2 test or Fisher exact probability method. Result Based on the Japanese study groupon pancreaticobiliary maljunction (JSGPM) -PBM classification criteria, ERCP was characterized by type A(10 cases, 33.3%) and type B (10 cases, 33.3%). In the surgical group, type C (11 cases, 36.7%) and type D(14 cases, 46.7%) were predominant, and the difference was statistically significant (P<0.05). The successrate of operation in both groups was 100%. The recovery feeding time of ERCP group and surgical group[5.0 (2.6, 6.4) vs 9.0 (8.0, 12.0) d, Z=3.489, P<0.001], postoperative hospitalization length [8.0 (5.3, 13.5) vs17.0 (14.0, 20.8) d, Z=6.408, P<0.001], the total hospitalization cost [2.8 (2.2, 4.1) vs 7.3 (5.4, 9.8) million yuan, Z=5.562, P<0.001], the above data in the ERCP group were lower than those in the surgical group. Thelaboratory test index of the liver and bile function in the two groups showed a decreasing trend after operation.After 6 months of follow-up, the postoperative disease remission rate was 86.2% (25/29) in the ERCP groupand 63.0% (17/27) in the surgical group. After 12 months of follow-up, the postoperative disease remissionrate was 96.0% (24/25) in the ERCP group and 88.5% (23/26) in the surgical group, and the difference was nostatistically significance (all P>0.05). Conclusion ERCP treatment for PBM children with JSGPM-PBM
type A and B with acute disease changes can effectively relieve symptoms and improve prognosis.
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Received: 30 March 2023
Published: 27 September 2023
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