TABLE 2.
Predictors of Therapeutic Endoscopy Utilization in Pediatric ARP
| Variables | Underwent therapeutic-ERCP, n=21 n (%) |
No therapeutic-ERCP, n=134 n (%) |
P |
|---|---|---|---|
|
| |||
| Sex, female | 14 (67) | 74 (55) | 0.325 |
|
| |||
| Ethnicity, Hispanic | (n=20) 11 (55) |
(n=125) 93 (74) |
0.074 |
|
| |||
| Race | (n=17) | (n=121) | |
| White | 14 (82) | 98 (81) | 0.414 |
| Multi-racial | 3 (18) | 9 (7) | – |
| Black | 0 (0) | 5 (4) | – |
| Asian | 0 (0) | 7 (6) | – |
| Other | 0 (0) | 2 (2) | – |
|
| |||
| Age at first acute attack, mean (SD), y | (n=18) 9.1 (5.1) | (n=122) 9.0 (5.0) | 0.967 |
|
| |||
| Exocrine insufficiency | 0/16 (0) | 2/111 (2) | 1.0 |
| Endocrine insufficiency | 0/19 (0) | 6/122 (5) | 1.0 |
|
| |||
| Alcoholic | 0/19 (0) | 2/131 (2) | 1.0 |
| Active smoker | 0/20 (0) | 1/130 (1) | 1.0 |
| Passive smoking exposure | 1/19 (5) | 11/121 (9) | 1.0 |
| Autoimmune pancreatitis | 3/13 (23) | 13/99 (13) | 0.394 |
| Other autoimmune diseases | 3/19 (16) | 11/124 (9) | 0.400 |
|
| |||
| Genetic Risk Factors: | |||
| PRSS1 | 0/11 (0) | 15/77 (19) | 0.199 |
| SPINK1 | 3/10 (30) | 7/68 (10) | 0.113 |
| CFTR | 3/10 (30) | 27/79 (34) | 1.0 |
| CTRC | 0/6 (0) | 5/42 (12) | 1.0 |
|
| |||
| Obstructive factors | 14/21 (67) | 36/131 (27) | 0.0004* |
| Pancreas divisum | 4/20 (20) | 9/126 (7) | 0.081 |
| Sphincter of Oddi disorders | 3/20 (15) | 2/124 (2) | 0.019* |
| Gallstones | 3/19 (16) | 6/128 (5) | 0.093 |
| Pancreatic duct mal-union | 2/20 (10) | 5/126 (4) | 0.245 |
| Duct obstruction | 0/20 (0) | 1/128 (1) | 1.0 |
| Annular pancreas | 0/20 (0) | 3/128 (2) | 1.0 |
| Choledochal cyst | 3/20 (15) | 2/128 (2) | 0.018* |
|
| |||
| Medications | |||
| Pain medications | 7/13 (54) | 34/102 (33) | 0.217 |
| Medical therapies | 8/19 (42) | 36/130 (28) | 0.198 |
| Pancreatic enzymes | 7/19 (37) | 25/130 (19) | 0.130 |
| Pancreatic enzymes (not for PI) | 7/19 (37) | 24/130 (18) | 0.076 |
| Vitamins/anti-oxidants | 1/18 (6) | 11/127 (9) | 1.0 |
| Steroids | 0/18 (0) | 0/125 (0) | – |
| Octreotide | 0/19 (0) | 2/128 (2) | 1.0 |
*
Statistically significant.
ARP: acute recurrent pancreatitis, SD: standard deviation, PRSS1: protease, serine 1, SPINK1: serine peptidase inhibitor, Kazal type 1, CFTR: cystic fibrosis transmembrane conductance regulator, CTRC: chymotrypsin C, PI: pancreatic insufficiency, ERCP: endoscopic retrograde cholangiopancreatography.