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Updated: Jul 15, 2026
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
Central pancreatectomy with pancreaticogastrostomy in children
Jason C Fisher1, Keith A Kuenzler, Lawrence Bodenstein
1Division of Pediatric Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY 10032, USA. jcf2102@columbia.edu
Insights
Pediatric central pancreatectomy with pancreaticogastrostomy offers a viable alternative to traditional reconstruction, potentially preserving pancreatic function in children. This approach may mitigate long-term risks of exocrine insufficiency and glucose intolerance.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Surgical Oncology
Background:
- Children undergoing pancreatic surgery face long-term risks of exocrine insufficiency and glucose intolerance.
- Preserving pancreatic parenchyma is crucial in pediatric pancreatic surgery.
- Central pancreatectomy is indicated for specific benign neoplasms and trauma in the pancreatic body/neck, avoiding extensive resection.
Observation:
- Traditional reconstruction after central pancreatectomy uses Roux-en-Y pancreaticojejunostomy.
- Pancreaticogastrostomy is an alternative reconstruction technique described in adults.
- This study describes two pediatric cases utilizing central pancreatectomy with pancreaticogastrostomy.
Findings:
- Pancreaticogastrostomy offers potential technical advantages over pancreaticojejunostomy for distal pancreatic remnant reconstruction.
- The described cases demonstrate the feasibility of central pancreatectomy with pancreaticogastrostomy in pediatric patients.
Implications:
- Central pancreatectomy with pancreaticogastrostomy may be a valuable technique for pediatric pancreatic surgery.
- This approach could help mitigate long-term endocrine and exocrine dysfunction in children.
- Further research is warranted to evaluate the long-term outcomes of this technique in pediatric populations.
Abstract:
Children requiring surgical intervention for pancreatic disease may be at risk long term for exocrine insufficiency and glucose intolerance. Pediatric surgeons must balance the need to perform adequate surgical resection while preserving as much normal pancreatic parenchyma as possible. Neoplasms of the middle pancreatic segment with low malignant potential and isolated trauma to the pancreatic body or neck represent 2 conditions where extensive pancreatic resection is unnecessary. Central pancreatectomy for such lesions is well described in adults. Reconstruction of the distal pancreatic remnant is traditionally performed via Roux-en-Y pancreaticojejunostomy. Pancreaticogastrostomy is an alternative approach that has been used to reconstruct the distal pancreas in the adults. Pancreaticogastrostomy offers several technical advantages over pancreaticojejunostomy. Because children may be uniquely susceptible to the long-term consequences of excessive pancreatic resection, 2 cases using this technique of central pancreatectomy with pancreaticogastrostomy are described.
