Pancreatectomies for Pediatric Pancreatic Tumors: A Single Institute Experience from 2007 to 2018
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Sep 2019 · 1 min read
In brief
In brief
Retrospective analysis of 104 pediatric pancreatectomy cases (2007-2018) demonstrates that organ-sparing resection techniques achieve excellent long-term outcomes (90.4% disease-free survival) despite higher short-term complication rates, particularly pancreatic fistula (35.6%). Study supports organ preservation as preferred approach for pediatric pancreatic tumors.
Written by the GCMD Library team from the article.
Background
To investigate the safety, feasibility, and complications of pancreatectomies for pediatric pancreatic tumors.
Methods
The medical records of pancreatectomy patients from January 2007 to January 2018 were retrospectively analyzed for perioperative factors and complications. Patients were divided into pancreatic head (n = 43), body (n = 18) and tail (n = 43) groups.
Results
Seventy-two girls and 32 boys (median age 10 years at diagnosis, range: 0–15 years) were enrolled and had solid pseudopapillary tumors (n = 73), pancreatoblastoma (n = 19), neuroendocrine tumors (n = 9), and others. Primary surgical procedures included pylorus-preserving pancreaticoduodenectomy (n = 10) and distal pancreatectomy with splenectomy (n = 4), and organ-sparing resection procedures included duodenum-preserving pancreas head resection (n = 25), middle segmental pancreatic resection (n = 15), spleen-preserving distal pancreatectomy (n = 37) and local enucleation (n = 13), with a median blood loss of 20 cm3 (range: 10–300 cm3). Short-term complications included pancreatic fistula (35.6%), bile leakage (2.9%), intraabdominal infection (21.2%), delayed gastric emptying (23.1%), and postpancreatectomy hemorrhage (5.8%). After a median follow-up of 38 months (range: 3–143 months), 94 patients (90.4%) were alive without tumor recurrence, 2 were alive after tumor recurrence, 1 pancreatoblastoma patient died from tumor recurrence, and 7 were lost to follow-up. Only 14 patients (14/96, 14.6%) had long-term complications at the outpatient follow-up.
Conclusions
Surgical resection was the main treatment for pancreatic tumors. Organ-sparing resection procedures led to good long-term results for pediatric pancreatic tumors, even if these procedures could cause a relatively high incidence of short-term complications (especially pancreatic fistula and postpancreatectomy hemorrhage).
Level of evidence
Level IV.