Related Experiment Video
Updated: Apr 26, 2026
Treatment of Middle-segment Pancreatic Benign Tumor Using Laparoscopic Central Pancreatectomy with End-to-end Pancreatic Duct Reconstruction
Published on: January 2, 2026
Surgical reconstruction and endoscopic pancreatic stent for traumatic pancreatic duct disruption
Insu Kawahara1, Kosaku Maeda, Shigeru Ono
1Division of Pediatric Surgery, Department of Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Insights
Management of major pancreatic duct injuries in children is challenging. Surgical repair, including anastomosis or stenting, can preserve pancreatic function and avoid distal pancreatectomy in isolated duct injuries.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Management of major pancreatic duct injuries in children is controversial.
- Nonoperative approaches are suitable for minor pancreatic injuries.
- Isolated pancreatic duct injury requires specific treatment strategies.
Observation:
- Three pediatric male patients with complete pancreatic duct disruption (Grade III) were treated.
- Enhanced computed tomography and endoscopic retrograde cholangiopancreatography were used for diagnosis.
- Surgical repair involved end-to-end anastomosis or pancreatic duct stenting.
Findings:
- All patients achieved uneventful postoperative recovery with an average hospitalization of 25.6 days.
- At a median 36-month follow-up, patients remained asymptomatic with normal pancreatic function.
- Persistent distal pancreatic duct dilatation was observed post-repair.
Implications:
- Distal pancreatectomy may not be routinely necessary for isolated pancreatic duct injuries in children.
- Surgical repair techniques can effectively manage severe pancreatic duct disruptions.
- Preserving pancreatic function is achievable through tailored surgical interventions.
Abstract:
Nonoperative management is acceptable treatment for minor pancreatic injuries. However, management of major pancreatic duct injury in children remains controversial. We present our experience in treating isolated pancreatic duct injury. We describe the cases of three male patients treated for complete pancreatic duct disruption in the past 5 years at our institution. We performed pancreatic duct repair to avoid distal pancreatectomy and to maintain normal pancreatic function. All patients underwent enhanced computed tomography and endoscopic retrograde cholangiopancreatography in the early period. The injuries were classified as grade III according to the American Association for the Surgery of Trauma classification. In two cases, we performed end-to-end anastomosis of the pancreatic duct during the delayed period. In the third case, we placed a stent across the disruption to the distal pancreatic duct. The patients' postoperative courses were uneventful, and the average hospitalization was 25.6 days after the procedure. At a median follow-up of 36 months (range 14-54 months), all patients remain asymptomatic, with normal pancreatic function, but with persistent distal pancreatic duct dilatation. We suggest that distal pancreatectomy should not be routinely performed in patients with isolated pancreatic duct injury.
