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Published on: November 20, 2021
Pancreatic resections for solid or cystic pancreatic masses in children
C O Muller1, F Guérin, D Goldzmidt
1Department of Pediatric Surgery, Bicêtre Hospital, Le Kremlin Bicêtre, France. cessolivia@gmail.com
Insights
Pediatric pancreatic resections for tumors and masses are safe and effective, demonstrating low short- and long-term complications. This study highlights successful surgical management and positive patient outcomes in children.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Solid pancreatic neoplasms in children are rare but require effective management strategies.
- Accurate diagnosis and appropriate surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To evaluate the diagnosis and management of pediatric solid pancreatic neoplasms.
- To assess surgical treatment types and their short- and long-term outcomes.
Main Methods:
- Retrospective review of pediatric patients undergoing pancreatic resection (1986-2008).
- Analysis of presenting symptoms, surgical procedures, and postoperative morbidity/mortality.
- Evaluation of long-term outcomes including growth and endocrine function.
Main Results:
- 18 patients with various pancreatic tumors (e.g., pseudopapillary tumors, neuroblastomas) and cysts were identified.
- Common symptoms included abdominal mass and jaundice; surgical procedures varied.
- Postoperative morbidity was 45%, with no surgical mortality. Long-term follow-up showed normal growth and minimal endocrine issues.
Conclusions:
- Pancreatic resections are safe and effective for pediatric pancreatic masses.
- The procedure offers low long-term morbidity, supporting its use in selected cases.
Objectives:
The aim of the study was to assess the diagnosis and management of solid pancreatic neoplasm in children and the type of surgical treatment, focusing on short- and long-term outcomes.
Methods:
We retrospectively reviewed the charts of all children who had undergone pancreatic resection for suspicion of pancreatic tumor in Kremlin Bicêtre Hospital, Paris, between 1986 and 2008. We studied the symptoms at diagnosis, the type of surgery, and the short- and long-term morbidity and mortality.
Results:
Of 18 patients identified, there were 7 pseudopapillary tumors, 3 neuroblastomas, 2 rhabdomyosarcomas, 1 acinar cell carcinoma, 1 endocrine cell carcinoma, 1 renal angiomyolipoma, and 3 pancreatic cysts. Symptoms at diagnosis were abdominal trauma, abdominal mass, and jaundice. Operative procedures were duodenopancreatectomy (11), mid-pancreatic resections (2), splenopancreatectomy (2), distal pancreatectomy (1), and tumorectomy (2). There were no deaths related to surgery. The postoperative morbidity rate was 45%, including 2 cases of fistula (11%) occurring after a mid-pancreatic resection and a pancreaticoduodenectomy. The median follow-up was 4.2 years (range 2-11). There was no diabetes mellitus, but there was 1 case of fat diet intolerance requiring pancreatic enzyme substitution. All of the children had a growth curve within normal limits.
Conclusions:
In this experience, pancreatic resections have proven to be a safe and efficient procedure, with low long-term morbidity, for the treatment of tumoral and selected nontumoral pancreatic masses.
