Endoscopy International Open
Endoscopic Retrograde Cholangiopancreatography in Pediatric Pancreas Divisum: Systematic Review
By Tareq Alsaleh, Saurabh Chandan, Shahab R. Khan and 12 others.
Abstract
Background
Pancreas divisum (PD) may be associated with recurrent acute pancreatitis (RAP) or chronic pancreatitis (CP), but data on ERCP outcomes in children with PD are limited. We conducted a systematic review of the clinical, technical, and safety outcomes of ERCP for PD in children.
Methods
Multiple databases were searched through May 2025. The primary outcome was clinical response, as defined by each individual study; secondary outcomes were symptom resolution, technical success, and post-ERCP pancreatitis (PEP). Because outcome definitions and interventions varied and no study included a control group, outcomes were summarized narratively and were not pooled.
Results
Eight retrospective studies including 247 patients were included. Clinical response ranged from 65.0% to 93.3% across six studies, symptom resolution from 19.1% to 54.1%, and technical success from 77.8% to 100%. Reported PEP ranged from 7.9% to 20.7%, with mixed patient and procedure denominators. Response ranged from 80.0% to 100% in RAP and 60.0% to 87.9% in CP, and was higher in RAP in three of four studies reporting both. Outcome definitions differed for every outcome examined.