Pediatric pancreatectomy for neoplasms: indications, outcomes, and implementation of minimally invasive surgery in a Ukrainian tertiary center

Abstract

Abstract Purpose Pancreatic neoplasms are rare in children, resulting in limited data on pancreatectomy within this population. Our case series aims to contribute to the understanding of the indications, long- and short-term outcomes of surgical treatment for both benign and malignant pancreatic neoplasms in children. Methods This is a retrospective review of pediatric patients (≤ 18 years old) who underwent resection for pancreatic neoplasms in a single tertiary referral center from July 2003 to November 2023. Results Overall, 31 patients with a median age of 13 years (range 1–15) were included in the study. Solid pseudopapillary neoplasm was diagnosed in 15 (48%) patients, neuroendocrine tumor– 7 (23%), serous cystadenoma– 2 (6%), pancreatic ductal adenocarcinoma– 2 (6%), pancreatoblastoma– 2 (6%), and lymphoma– 1 (3%). There were two rare cases of mature cystic teratoma and pancreatic paraganglioma. 20 (65%) distal pancreatectomies, 7 (23%) pancreaticoduodenectomies, and 4 (13%) tumor enucleations were performed. The laparoscopic approach was applied in 9 (29%) cases in the last seven years. There were 4 (13%) complications Clavien-Dindo ≥ 3, and no cases of perioperative mortality. The median follow-up was 114 months (range 10–131 months). 87% (27/31) of patients were alive without tumor recurrence. Conclusions Surgical treatment remains the best chance for cure in patients with pancreatic neoplasms. These complex surgeries can be safely performed in the pediatric population with good long-term results. Advances in minimally invasive technique allow transition to less traumatic surgery in these patients.

Keywords

• Pediatric pancreatic surgery
• Minimally invasive pancreatic resection
• Pediatric malignancies
• Pancreaticoduodenectomy in children