Treatment and Services
Nationwide Children’s offers the full range of therapies for children with pancreas conditions. Treating pancreatitis involves maintaining good nutrition during periods when it is difficult to eat, relieving pain, draining or replacing fluids and keeping enzymes in balance. Depending on your child’s diagnosis, it may also involve removing stones, opening blockages or performing a more advanced procedure.
After evaluation by our team and a confirmed diagnosis, we will work with your family to design a care plan that offers your child the best chance at healing, comfort and a good quality of life. Options are tailored to your child and their condition, and may include:
- Endoscopic ultrasound (EUS): EUS uses the process of an endoscopy with the benefits of an ultrasound. Endoscopy uses a camera built into a thin, flexible tube, and an ultrasound uses sound waves to create detailed images of organs. This combination creates a clearer picture of any pancreas problems for your child’s doctor to diagnose and treat. Interventions can also be performed, such as needle aspiration of small fluid collections, needle biopsy for diagnosing certain conditions, stents for larger fluid collections, and injections for pain control.
- Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is used to diagnose and treat problems of the bile duct and pancreatic duct, by accessing the connections to the pancreas, liver, and bile ducts/gallbladder from the small intestine. While the patient is under anesthesia, the doctor performs an ERCP with X-ray assistance to visualize problems such as narrowing, blockages, stones, inflamed ducts or other abnormalities. During the ERCP, the doctor can also make some repairs if needed, such as removing a pancreatic stone or placing a bile duct or pancreatic duct stent to improve drainage.
- Medications: Sometimes, pancreatic problems can be treated by taking medicine. PERT therapy (pancreatic enzyme replacement therapy) is an effective way to supply your child with the proper enzymes when their pancreas cannot do it on its own. Depending on the diagnosis, your child’s doctor may also recommend anti-inflammatory drugs, pain medication or anti-nausea medications, which are aimed to improve your child’s quality of life.
- Nutritional therapy: As the pancreas’ primary purpose is to help digest food, nutritional therapy is a non-invasive way to promote, restore and maintain health. With the experience of our dietitians, nutritionists and the entire multidisciplinary team, a personalized nutritional therapy plan can be created and adjusted as needed. Plans can include use of intravenous (IV) fluids, supplementing with vitamins and pancreatic enzymes, and monitoring overall diet and nutrition. This can help support a better quality of life for your child in a natural way.
- Pain management: Nationwide Children’s offers a variety of safe and effective methods for pain relief and management to improve your child’s quality of life. We incorporate the expertise of pediatric advanced pain medicine specialists with the most up-to-date science and technology to minimize discomfort both in and out of the hospital. Your child’s pain management plan may include non-medical strategies as well as a range of medications, including non-opioid options.
- Pancreatic endocrine function monitoring: Pediatric endocrinologists follow all pancreas patients closely for the onset of diabetes. Specialized measurement of islet cell function tells your child’s medical team if there is a need for external glucose control through medication.
- Pancreatic exocrine function testing: Direct pancreatic function testing measures the degree of pancreatic insufficiency. Exocrine insufficiency can cause fat in the stool, weight loss, delayed/slowed growth and malnutrition.
- Surgical intervention: The physicians at Nationwide Children’s consider all treatment options available to create the best possible outcome for your child. Even with the best non-invasive or minimally invasive resources, surgery may become necessary. Your child’s pancreas care team will discuss the best surgical options based on your child’s specific pancreas anatomy and morphology, your child’s specific clinical and lifestyle needs, and your child’s genetic risk factors. Options may include:
- Total pancreatectomy with islet autotransplantation (TPIAT)
- Partial resections, such as the Whipple procedure (pancreaticoduodenectomy) or distal pancreatectomy, to remove the portion of the pancreas causing pain or drainage problems
- Operations combining drainage and resection, known as duodenum-preserving pancreatic head resections, including the Beger procedure, Berne procedure, and Frey procedure. These procedures can remove inflammatory masses in the head of the pancreas while also improving ductal drainage.