Endoscopic pancreatic interventions in children

Abstract

   Aim. To increase the efficiency of surgical treatment for children with pancreatic malformations and diseases using endoscopic interventions.   Materials and methods. The study enrolled 39 children aged 3–17 years who underwent 58 endoscopic interventions.   Results. Transpapillary interventions were performed in 14 children with pancreatic duct abnormalities. Stenosis of the proximal pancreatic ducts was revealed in 5 observations – stenting was performed. Lithiasis of Wirsung's duct was confirmed in 4 observations, an abnormality in the form of an incomplete pancreas divisum was revealed in 3 of them. Pancreas divisum was detected in 1 patient, sphincterotomy of the minor duodenal papilla was performed. Transmural interventions were carried out in 24 observations: puncture – in 10 patients with intra- or parapancreatic cystic formations, drainage – in 14 patients with pseudocysts. Combined transpapillary and transmural surgery was performed in a child with traumatic pancreatic disruption.   Conclusion. Transpapillary interventions prove to effectively eliminate hypertension in the pancreatic ducts in children. Transmural procedures can be used to drain pancreatic pseudocysts in children.