Approaches of pancreatic surgery for tumors in children
Objective To explore the tumor characteristics,surgical approaches and outcomes of pancreatic tumors in children.Methods From 2003 to 2020,demographic profiles,preoperative examinations,perioperative findings,short-term postoperative complications and long-term outcomes were retrospectively reviewed for 29 children aged under 18 years undergoing partial pancreatectomy for pancreatic tumors.There were 6 boys and 23 girls with an average age of 10.6(3-15)year.The most common histological tumors were solid pseudopapillary tumor(25/29)and pancreatoblastoma(2/29).Partial pancreatectomy was performed according to tumor locations.Results All surgical procedures were sucessful.Bile leakage(n=1)and hemorrhage(n=1)improved gradually after conservative treatment.There was no perioperative death or pancreatic fistula.The overall complication rate was 6.9％.During a median follow-up period of 50.8 month,survival rate was up to 100％.The complication rate was 10.3％.There were pancreatic exocrine insufficiency(n=1),endocrine insufficiency(n=1)and biliary-enteric anastomotic stenosis(n=1).No intrapancreatic tumor recurrence was noted.Three children developed postoperative liver metastases with a recurrent rate of 10.3％.Conclusions Partial pancreatectomy is both effective and safe for pancreatic tumors in children.End-to-end dunking pancreaticojejunostomy is recommended for preventing postoperative pancreatic fistula during pancreaticoduodenectomy and central pancreatectomy.The overall prognosis of pediatric pancreatic tumors is decent even in children with preoperative metastasis or recurrent pancreatic tumors.
NETL
NSTL
万方数据
维普
