Pancreatectomies for pediatric pancreatic tumors: A single institute experience from 2007 to 2018.
J Pediatr Surg
; 55(9): 1722-1726, 2020 Sep.
Article
en En
| MEDLINE
| ID: mdl-31575410
ABSTRACT
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 (nâ¯=â¯43), body (nâ¯=â¯18) and tail (nâ¯=â¯43) groups.RESULTS:
Seventy-two girls and 32 boys (median age 10â¯years at diagnosis, range 0-15â¯years) were enrolled and had solid pseudopapillary tumors (nâ¯=â¯73), pancreatoblastoma (nâ¯=â¯19), neuroendocrine tumors (nâ¯=â¯9), and others. Primary surgical procedures included pylorus-preserving pancreaticoduodenectomy (nâ¯=â¯10) and distal pancreatectomy with splenectomy (nâ¯=â¯4), and organ-sparing resection procedures included duodenum-preserving pancreas head resection (nâ¯=â¯25), middle segmental pancreatic resection (nâ¯=â¯15), spleen-preserving distal pancreatectomy (nâ¯=â¯37) and local enucleation (nâ¯=â¯13), with a median blood loss of 20â¯cm3 (range 10-300â¯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 38â¯months (range 3-143â¯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.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Pancreatectomía
/
Neoplasias Pancreáticas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article