Related Experiment Video
Updated: Jun 25, 2025
Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors
Published on: February 9, 2024
Preservation of Pancreatic Function Should Not Be Disregarded When Performing Pancreatectomies for Pancreatoblastoma
1Division of Surgical Oncology, Fundeni Clinical Institute, Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Fundeni Street no. 258, 022328 Bucharest, Romania.
Insights
Organ-sparing pancreatectomies, like central pancreatectomies, offer better long-term pancreatic function for children with pancreatoblastoma (PB). These procedures provide similar oncological safety to standard resections but improve quality of life.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Pediatric Gastroenterology
Background:
- Complete surgical resection is key for long-term survival in pediatric pancreatoblastoma (PB).
- Standard pancreatic resections can cause significant long-term pancreatic functional deficiencies, impacting children's growth and development.
- Organ-sparing pancreatectomies are gaining traction for specific pediatric conditions, but their role in PB is understudied.
Purpose of the Study:
- To review early and late outcomes of pancreatectomies in children with PB.
- To explore the impact of pancreatic deficiencies on pediatric development and quality of life.
- To evaluate the potential role and outcomes of organ-sparing pancreatectomies in pediatric PB surgery.
Main Methods:
- Literature review of studies on pancreatectomies in children with PB.
- Analysis of outcomes including long-term functional deficiencies and oncological safety.
- Comparison of standard versus organ-sparing pancreatectomy approaches.
Main Results:
- Organ-sparing pancreatectomies, especially central pancreatectomies, show improved long-term pancreatic function.
- These approaches reduce the impact on children's development and quality of life.
- Oncological outcomes are comparable to standard resections without compromising safety.
Conclusions:
- Preserving pancreatic function is crucial in pediatric PB surgery.
- Organ-sparing pancreatectomies, particularly central pancreatectomies, are a viable option for select pediatric PB patients.
- These techniques offer comparable oncological results with significantly better functional outcomes.
Abstract:
Complete surgical resection in the context of a multimodal approach has been associated with excellent long-term survival in children diagnosed with pancreatoblastoma (PB). Traditionally, curative intent surgery for PB implies standard pancreatic resections such as pancreaticoduodenectomies and distal pancreatectomies with splenectomies, surgical procedures that may lead to significant long-term pancreatic functional deficiencies. Postoperative pancreatic functional deficiencies are particularly interesting to children because they may interfere with their development, considering their long life expectancy and the significant role of pancreatic functions in their nutritional status and growth. Thus, organ-sparing pancreatectomies, such as spleen-preserving distal pancreatectomies and central pancreatectomies, are emerging in specific tumoral pathologies in children. However, data about organ-sparing pancreatectomies' potential role in curative-intent PB surgery in children are scarce. Based on the literature data, the current review aims to present the early and late outcomes of pancreatectomies in children (including long-term deficiencies and their potential impact on the development and quality of life), particularly for PB, and further explore the potential role of organ-sparing pancreatectomies for PB. Organ-sparing pancreatectomies are associated with better long-term pancreatic functional outcomes, particularly central pancreatectomies, and have a reduced impact on children's development and quality of life without jeopardizing their oncological safety. The long-term preservation of pancreatic functions should not be disregarded when performing pancreatectomies for PB in children. A subset of patients with PB might benefit from organ-sparing pancreatectomies, particularly from central pancreatectomies, with the same oncological results as standard pancreatectomies but with significantly less impact on long-term functional outcomes.
