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.
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.
Authors: Nicholas A Shorter; Richard D Glick; David S Klimstra; Murray F Brennan; Michael P Laquaglia Journal: J Pediatr Surg Date: 2002-06 Impact factor: 2.545
Authors: P Senthilnathan; Nikunj Patel; V P Nalankilli; C Palanivelu; R Parthasarthi; P Praveenraj Journal: Pancreatology Date: 2014-07-02 Impact factor: 3.996
Authors: C O Muller; F Guérin; D Goldzmidt; V Fouquet; S Franchi-Abella; M Fabre; S Branchereau; H Martelli; F Gauthier Journal: J Pediatr Gastroenterol Nutr Date: 2012-03 Impact factor: 2.839
Authors: Yesenia Rojas; Carla L Warneke; Chetan A Dhamne; Kuojen Tsao; Jed G Nuchtern; Kevin P Lally; Sanjeev A Vasudevan; Andrea A Hayes-Jordan; Darrell L Cass; Cynthia E Herzog; M John Hicks; Eugene S Kim; Mary T Austin Journal: J Pediatr Surg Date: 2012-12 Impact factor: 2.545
Authors: Giuseppe d'Ambrosio; Laura del Prete; Chiara Grimaldi; Arianna Bertocchini; Cristina Lo Zupone; Lidia Monti; Jean de Ville de Goyet Journal: J Pediatr Surg Date: 2014-04 Impact factor: 2.545
Authors: Sanjeev A Vasudevan; Tu-Anh N Ha; Huirong Zhu; Todd E Heaton; Michael P LaQuaglia; Joseph T Murphy; Wesley E Barry; Catherine Goodhue; Eugene S Kim; Jennifer H Aldrink; Stephanie F Polites; Harold J Leraas; Henry E Rice; Elisabeth T Tracy; Timothy B Lautz; Riccardo A Superina; Andrew M Davidoff; Max R Langham; Andrew J Murphy; Andreana Bütter; Jacob Davidson; Richard D Glick; James Grijalva; Kenneth W Gow; Peter F Ehrlich; Erika A Newman; Dave R Lal; Marcus M Malek; Annie Le-Nguyen; Nelson Piché; David H Rothstein; Scott S Short; Rebecka Meyers; Roshni Dasgupta Journal: Pediatr Blood Cancer Date: 2020-07-13 Impact factor: 3.167
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17