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Tailored resective pancreatic surgery for pediatric patients with chronic pancreatitis
Ansgar M Chromik1, Matthias H Seelig, Benjamin Saewe
1Department of Visceral and General Surgery, Pancreas Center, St. Josef Hospital, Ruhr-University Bochum, D-44791 Bochum, Germany.
Insights
Organ-preserving resective pancreatic surgery for pediatric chronic pancreatitis (CP) showed promising results. This approach offers effective pain control with low morbidity and mortality in children unresponsive to conservative management.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pancreatic Diseases
Background:
- Surgical treatment for pediatric chronic pancreatitis (CP) predominantly involves nonresective procedures.
- Limited data exists on organ-preserving resective pancreatic surgery for pediatric CP.
Purpose of the Study:
- To identify indications, techniques, and outcomes of organ-preserving resective pancreatic surgery for pediatric CP.
- To evaluate the safety and efficacy of these procedures in a pediatric population.
Main Methods:
- Retrospective chart review of pediatric patients undergoing pancreatic surgery for CP over 4 years.
- Analysis of patient demographics, surgical procedures, operative details, and postoperative outcomes.
Main Results:
- Six pediatric patients (ages 7-18) underwent various resective procedures (duodenum-preserving pancreatic head resection, middle segmental resection, distal pancreatectomy).
- Etiologies included idiopathic, posttraumatic, pancreas divisum, and situs inversus.
- No mortality or major complications occurred; improved pain control was observed in 5/6 patients with no endocrine/exocrine insufficiency during follow-up.
Conclusions:
- Tailored organ-preserving resective pancreatic surgery is feasible and safe in pediatric patients with CP.
- This approach offers a viable option for refractory pediatric CP cases, demonstrating low morbidity and mortality.
Background:
Surgical treatment for chronic pancreatitis (CP) in children comprises predominantly nonresective draining procedures. The purpose of this study was to identify indications, techniques, and results of organ-preserving resective pancreatic procedures for pediatric CP at our institution.
Patients And Methods:
A retrospective chart review was performed of all children undergoing pancreatic surgery for CP over a period of 4 years.
Results:
Overall, 6 pediatric patients (3 male, 3 female, ages 7-18 years) underwent a duodenum-preserving pancreatic head resection (3), a middle segmental pancreatic resection (2), or a distal pancreatectomy (1) for CP of different etiologies (idiopathic 2, posttraumatic 2, pancreas divisum 1, situs inversus 1). No mortality or major surgical complication occurred. Mean operative time was 294 min (207-412 min) and intraoperative blood loss was 541 mL (100-1300 mL). Postoperative hospital stay was 13 days (10-18 days). No endocrine or exocrine insufficiency occurred during follow up of 46 months (25-50 m), and pain control was improved in 5 of 6 patients.
Conclusions:
Tailored organ-preserving resective pancreatic surgery can be performed with low morbidity and mortality in pediatric patients with CP and not responding to conservative treatment.
