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Pancreatic Surgery in Children: Complex, Safe, and Effective.
Fuchs, Juri; Loos, Martin; Kinny-Köster, Benedict; Hackert, Thilo; Schneider, Martin; Mehrabi, Arianeb; Berchtold, Christoph; Al-Saeedi, Mohammed; Müller, Beat P; Strobel, Oliver; Feißt, Manuel; Kessler, Markus; Günther, Patrick; Büchler, Markus W.
Affiliation
  • Fuchs J; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Loos M; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Kinny-Köster B; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Hackert T; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Schneider M; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Mehrabi A; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Berchtold C; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Al-Saeedi M; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Müller BP; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Strobel O; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Feißt M; Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
  • Kessler M; Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Günther P; Division of Pediatric Surgery, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
  • Büchler MW; Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Ann Surg ; 280(2): 332-339, 2024 Aug 01.
Article in En | MEDLINE | ID: mdl-38386903
ABSTRACT

OBJECTIVE:

The aim of this study was to assess indications for and report outcomes of pancreatic surgery in pediatric patients.

BACKGROUND:

Indications for pancreatic surgery in children are rare and data on surgical outcomes after pediatric pancreatic surgery are scarce.

METHODS:

All children who underwent pancreatic surgery at a tertiary hospital specializing in pancreatic surgery between 2003 and 2022 were identified from a prospectively maintained database. Indications, surgical procedures, and perioperative as well as long-term outcomes were analyzed.

RESULTS:

In total, 73 children with a mean age of 12.8 years (range 4 mo to 18 y) underwent pancreatic surgery during the observation period. Indications included chronic pancreatitis (n=35), pancreatic tumors (n=27), and pancreatic trauma (n=11). Distal pancreatectomy was the most frequently performed procedure (n=23), followed by pancreatoduodenectomy (n=19), duodenum-preserving pancreatic head resection (n=10), segmental pancreatic resection (n=7), total pancreatectomy (n=3), and others (n=11). Postoperative morbidity occurred in 25 patients (34.2%), including 7 cases (9.6%) with major complications (Clavien-Dindo≥III). There was no postoperative (90-d) mortality. The 5-year overall survival was 90.5%. The 5-year event-free survival of patients with chronic pancreatitis was 85.7%, and 69.0% for patients with pancreatic tumors.

CONCLUSION:

This is the largest single-center study on pediatric pancreatic surgery in a Western population. Pediatric pancreatic surgery can be performed safely. Centralization in pancreatic centers with high expertise in surgery of adult and pediatric patients is important as it both affords the benefits of pancreatic surgery experience and ensures that surgical management is adapted to the specific needs of children.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Pancreatectomy / Pancreatic Diseases Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Ann Surg Year: 2024 Type: Article Affiliation country: Germany

Full text: 1 Database: MEDLINE Main subject: Pancreatectomy / Pancreatic Diseases Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Ann Surg Year: 2024 Type: Article Affiliation country: Germany