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Updated: Jul 2, 2025
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
Pancreatic Surgery in Children: Complex, Safe, and Effective
Juri Fuchs1, Martin Loos1, Benedict Kinny-Köster1
1Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Insights
Pediatric pancreatic surgery is safe and effective for conditions like chronic pancreatitis, tumors, and trauma. Centralizing care in specialized centers improves outcomes for children needing complex pancreatic operations.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Pediatric pancreatic surgery indications are rare.
- Data on surgical outcomes in children are limited.
Purpose of the Study:
- To assess indications for pancreatic surgery in pediatric patients.
- To report surgical outcomes in children undergoing pancreatic procedures.
Main Methods:
- Retrospective analysis of a prospectively maintained database.
- Inclusion of pediatric patients (4 months to 18 years) undergoing pancreatic surgery from 2003-2022.
- Analysis of indications, procedures, and perioperative/long-term outcomes.
Main Results:
- 73 children underwent pancreatic surgery for chronic pancreatitis (35), tumors (27), or trauma (11).
- Distal pancreatectomy was most common (n=23).
- 5-year overall survival was 90.5%; event-free survival varied by indication (85.7% for pancreatitis, 69.0% for tumors). No 90-day mortality.
Conclusions:
- This is the largest single-center study on pediatric pancreatic surgery in a Western population.
- Pediatric pancreatic surgery can be performed safely.
- Centralization in expert pancreatic centers is crucial for optimal pediatric surgical management.
Objective:
The aim of this study was to assess indications for and report outcomes of pancreatic surgery in pediatric patients.
Background:
Indications for pancreatic surgery in children are rare and data on surgical outcomes after pediatric pancreatic surgery are scarce.
Methods:
All children who underwent pancreatic surgery at a tertiary hospital specializing in pancreatic surgery between 2003 and 2022 were identified from a prospectively maintained database. Indications, surgical procedures, and perioperative as well as long-term outcomes were analyzed.
Results:
In total, 73 children with a mean age of 12.8 years (range: 4 mo to 18 y) underwent pancreatic surgery during the observation period. Indications included chronic pancreatitis (n=35), pancreatic tumors (n=27), and pancreatic trauma (n=11). Distal pancreatectomy was the most frequently performed procedure (n=23), followed by pancreatoduodenectomy (n=19), duodenum-preserving pancreatic head resection (n=10), segmental pancreatic resection (n=7), total pancreatectomy (n=3), and others (n=11). Postoperative morbidity occurred in 25 patients (34.2%), including 7 cases (9.6%) with major complications (Clavien-Dindo≥III). There was no postoperative (90-d) mortality. The 5-year overall survival was 90.5%. The 5-year event-free survival of patients with chronic pancreatitis was 85.7%, and 69.0% for patients with pancreatic tumors.
Conclusion:
This is the largest single-center study on pediatric pancreatic surgery in a Western population. Pediatric pancreatic surgery can be performed safely. Centralization in pancreatic centers with high expertise in surgery of adult and pediatric patients is important as it both affords the benefits of pancreatic surgery experience and ensures that surgical management is adapted to the specific needs of children.
