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2017 ; 11
(4
): 474-480
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Endoscopic Management of Pancreatic Fluid Collections in Children
#MMPMID28514841
Nabi Z
; Talukdar R
; Reddy DN
Gut Liver
2017[Jul]; 11
(4
): 474-480
PMID28514841
show ga
The incidence of acute pancreatitis in children has increased over the last few
decades. The development of pancreatic fluid collection is not uncommon after
severe acute pancreatitis, although its natural course in children and
adolescents is poorly understood. Asymptomatic fluid collections can be safely
observed without any intervention. However, the presence of clinically
significant symptoms warrants the drainage of these fluid collections. Endoscopic
management of pancreatic fluid collection is safe and effective in adults. The
use of endoscopic ultrasound (EUS)-guided procedure has improved the efficacy and
safety of drainage of pancreatic fluid collections, which have not been well
studied in pediatric populations, barring a scant volume of small case series.
Excellent results of EUS-guided drainage in adult patients also need to be
verified in children and adolescents. Endoprostheses used to drain pancreatic
fluid collections include plastic and metal stents. Metal stents have wider
lumens and become clogged less often than plastic stents. Fully covered metal
stents specifically designed for pancreatic fluid collection are available, and
initial studies have shown encouraging results in adult patients. The future of
endoscopic management of pancreatic fluid collection in children appears
promising. Prospective studies with larger sample sizes are required to establish
their definitive role in the pediatric age group.