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Updated: Mar 11, 2026
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
Pancreaticoduodenectomy for pediatric and adolescent pancreatic malignancy: A single-center retrospective analysis
Erika B Lindholm1, Abdulaziz K Alkattan1, Sara J Abramson2
1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Insights
Pancreaticoduodenectomy (PD) is a viable surgical option for pediatric pancreatic cancers, showing acceptable survival rates and manageable complications. Tumor histology significantly influences long-term outcomes in children.
Area of Science:
- Pediatric surgery
- Surgical oncology
- Gastrointestinal surgery
Background:
- Pancreaticoduodenectomy (PD) is a complex procedure primarily studied in adults.
- Limited data exists on PD outcomes specifically in the pediatric population.
Purpose of the Study:
- To retrospectively analyze the morbidity and mortality associated with pancreaticoduodenectomy in pediatric patients.
- To evaluate the feasibility and outcomes of PD for pediatric pancreatic malignancies.
Main Methods:
- Retrospective analysis of 12 pediatric patients (≤18 years) who underwent PD between 1993 and 2015.
- Data collection included demographics, disease characteristics, treatments, and postoperative outcomes.
- Study design is Level IV, a retrospective study without a comparison group.
Main Results:
- The study included 12 children with various pancreatic malignancies, including pancreatoblastoma and solid pseudopapillary tumors.
- No operative deaths occurred; however, complications included grade II (34%), IIIb (chest tube), and IV (reexploration).
- Long-term morbidity was common, with 83% requiring pancreas exocrine supplementation. Survival varied by histology, with 42% alive at a mean of 77.4 months.
Conclusions:
- Pancreaticoduodenectomy is a feasible surgical approach for pediatric pancreatic malignancies.
- The procedure is associated with acceptable morbidity and overall survival in children.
- Tumor histology is a key determinant of long-term outcomes following PD in pediatric patients.
Purpose:
While pancreaticoduodenectomy (PD) has been extensively studied in adults, there are few data pertaining specifically to pediatric patients. We retrospectively analyzed PD-associated morbidity and mortality in pediatric patients.
Methods:
Our analytic cohort included all consecutive patients ≤18years of age treated at our institution from 1993 to 2015 who underwent PD. Patient data (demographics, disease characteristics, surgical and adjuvant treatment, length of hospital stay, and postoperative course) were extracted from the medical records.
Results:
We identified 12 children with a median age of 9years (7 female, 5 male). Final diagnoses were pancreatoblastoma (n=3), solid pseudopapillary tumor (n=3), neuroblastoma (n=2), rhabdomyosarcoma (n=2), and neuroendocrine carcinoma (n=2). Four patients underwent PD for resection of recurrent disease. 75% (9/12 patients) received neoadjuvant therapy. The median operative time was approximately 7hours with a mean blood loss of 590cm3. The distal pancreas was invaginated into the posterior stomach (n=3) or into the jejunum (n=5) or was directly sewn to the jejunal mucosa (n=4). There were no operative deaths. There were 4 patients (34%) with grade II complications, 1 with a grade IIIb complication (chest tube), and 1 with a grade IV complication (reexploration). The most common long-term morbidity was pancreas exocrine supplementation (n=10; 83%). Five patients (42%) diagnosed with either solid pseudopapillary tumor or rhabdomyosarcoma are currently alive with a mean survival of 77.4months.
Conclusion:
Pancreaticoduodenectomy is a feasible management strategy for pediatric pancreatic malignancies and is associated with acceptable morbidity and overall survival. Long-term outcome is mostly dependent on histology of the tumor.
Level Of Evidence:
Level IV; retrospective study with no comparison group.
