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Objective: To analyze the clinical characteristics of chronic pancreatitis (CP) and evaluate its impact on growth of children. Methods: A retrospective study was conducted in 94 children (male 49 cases, female 45 cases) who were diagnosed with CP in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from August 2008 to July 2015. Clinical characteristics, such as features of abdominal pain, etiologies, image data, levels of serum amylase and lipase, and physical development data were extracted from electronic medical records. The comparison between groups based on etiology or with normal control was performed with student's t test. Results: The age of first episode was (8.2±3.7) years. There were 61 (65%) children diagnosed with idiopathic CP, and 25 (27%) with anatomic abnormalities. The age of onset in the group with anatomic abnormalities was lower than that in the idiopathic CP group ((6.3±3.5) vs. (8.9±3.4) years, t= 3.211, P= 0.002). There were 51 (54%) patients with serum amylase elevation, 41(44%) patients with lipase elevation, and 35 (37%) with elevation in both. The questionnaire showed that 28 out of 30 children had moderate to severe abdominal pain. The patients' weight standard score (SDS) was significantly lower than the overall average in normal control (-0.4±1.1 vs. 0, t= -3.308, P= 0.001). Meanwhile, the mean level of insulin like growth factor-1 (IGF-1) SDS of 35 children was significantly decreased (-1.8±1.8 vs. 0, t= -6.136, P< 0.01). There were 69% (37/54) patients diagnosed by magnetic resonance cholangiopancreatography (MRCP) combined with magnetic resonance imaging (MRI), higher than that diagnosed by abdominal ultrasound (29%, 27/94). Conclusions: Idiopathic CP and anatomic abnormalities were the two main etiologies. Normal level of serum amylase and lipase or negative finding of ultrasound cannot exclude CP, while MRCP and MRI should be considered to improve CP diagnostic rate. It is noteworthy that growth delay would happen in children with CP history.

Background: Detailed preoperative delineation of biliary tract anatomy plays a pivotal role in guiding surgeons completing laparoscopic cholecystectomy (LC) smoothly. Hereby, we retrospectively investigated the potential impact of preoperative magnetic resonance cholangiopancreatography (MRCP) on LC., Patients and Methods: In this study, clinical data of LC patients who received conventional preoperative examinations from January 2008 to December 2010 (Ctrl group, n = 300) versus conventional examinations plus extra preoperative MRCP assessment between January 2011 and December 2013 (MRCP group, n = 300) were randomly retrieved. The ratios of conversion to open cholecystectomy and various postoperative morbidities were respectively analyzed., Results: In total, the incidences of operation conversion, postoperative remnant cystic duct stone, and choledocholithiasis in the MRCP group were 12 (4.0%), 1 (0.3%), and 2 (0.7%), respectively, all evidently lower than those in the Ctrl group: 41 (13.7%), 7 (2.3%), and 9 (3.0%). In addition, the MRCP group also presented with fewer cases of bile duct injury and incidental gallbladder carcinoma compared with the Ctrl group (1 versus 5 and 1 versus 2, respectively), although none of the variances was statistically significant., Conclusions: Our results demonstrated that preoperative MRCP had a robust safeguarding effect on LC and deserves further promotion.