Endoscopic retrograde cholangiopancreatography in the treatment of pancreaticopleural fistula in children

Table 2 Clinical symptoms, treatments, and outcomes of seven children with pancreaticopleural fistula

Patients	1	2	3	4	5	6	7
Age (yr)	8	10	3	2	5	8	10
Gender	Male	Female	Male	Male	Female	Female	Female
Symptom	Fatigue, poor appetite, intermittent fever, abdominal distention	Intermittent chest tightness and upper abdominal pain	Chronic pancreatitis, recurrent abdominal pain	Wheezing, shortness of breath, repeated bloody pleural effusion	Abdominal pain for half a year, fever and chest tightness	Intermittent chest tightness and dyspnea for more than 20 d	Chest pain with dyspnea
Etiology	Suspected trauma and pseudocyst	Dilatation and calculus of pancreatic duct	Congenital pancreatic duct dysplasia and pseudocyst	Pseudocyst and dilatation of pancreatic duct	Pseudocyst and dilatation of pancreatic duct	Dilatation and calculus of pancreatic duct	Pancreatic duct stone, pseudocyst, dilatation of pancreatic duct
Diagnosis	laboratory examination, B ultrasound, MRCP	laboratory examination, MRCP	laboratory examination, enhanced CT, MRC, ERCP	laboratory examination, CT, B ultrasound, MRCP	laboratory examination, CT, B ultrasound, MRCP	laboratory examination, CT, MRCP, ERCP	laboratory examination, CT, B ultrasound, MRCP
Location of pleural effusion	Right	Bilateral	Bilateral	Left	Right	Bilateral	Right
Amylase in pleural effusion (U/L)	6625	10477	3178	50465	1584	65000	25549
Conservative treatment time (d)	10	21	60	24	19	20	10
ERCP treatment	Yes (Surgical treatment after ERCP failure)	No (Operation)	Yes	Yes	No (Operation)	Yes	Yes
Serum amylase concentration before operation (U/L)	889.4	153	367	429	93.0	292	283
Serum amylase concentration after operation (U/L)	102		267	315		105	110
Time for amylase to return to normal (Days after operation)			23	10		9	4
Lipase concentration before operation/ERCP (U/L)	567	1051		355.4	115	106	731.2
Lipase concentration after operation/ERCP (U/L)						51.7	62.4
Stop somatostatin pump maintenance time (days after operation)			19	5		3	4
Postoperative recovery time of eating (days after operation)	3	3	6	6		4	15
Times of fever treated conservatively	1	3	5	3	4		Normal temperature
Chest closed drainage time (days after operation)	-	-	16	-	-		-
Postoperative hospital stay (d)	20	30	30	12		12	23
Total length of stay (d)	30	52	90	36		32	33

CT: Computed tomography; ERCP: Endoscopic retrograde cholangiopancreatography; MRCP: Magnetic resonance cholangiopancreatography.