ArticleFrontiers in pediatrics2026
Clinical and stool microbiome correlates of simple post-ERCP hyperamylasemia in children undergoing therapeutic ERCP for pancreatobiliary obstructive disorders: an exploratory pilot study.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Simple post-ERCP hyperamylasemia is a common biochemical finding after therapeutic endoscopic retrograde cholangiopancreatography (ERCP), but pediatric data integrating procedural characteristics with stool microbiome features remain limited. Methods: We performed an exploratory single-center observational pilot study of 24 successful therapeutic ERCP procedures in children younger than 18 years with pancreatobiliary obstructive disorders between January 2024 and December 2025. The primary endpoint was simple post-ERCP hyperamylasemia, defined as serum amylase >3 times the upper limit of normal within 24 h after ERCP without new or worsening abdominal pain. Baseline clinical variables, predefined stool microbiome features derived from pre-ERCP metagenomic data (Shannon diversity, Results: Hyperamylasemia occurred in 8/24 procedures (33.3%). Compared with non- hyperamylasemia group, the affected children had higher baseline gamma-glutamyl transferase and C-reactive protein, longer procedure time, more difficult cannulation, more inadvertent pancreatic duct cannulation, more pancreatic contrast injection, and more rescue precut access. Stool microbiome features in the hyperamylasemia group included lower Shannon diversity, higher Conclusion: In this pilot dataset, simple post-ERCP hyperamylasemia clustered with technically demanding procedures and a low-diversity,
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