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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.
Annals of Surgery
|February 22, 2024
Summary
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.
