Pancreatic operations are not commonly performed in the pediatric age group. Tumors, chronic pancreatitis, trauma and hyperinsulinemic hypoglycemia are the main diseases leading to pancreatic resections in children. Excluding patients with acute pancreatitis and pseudocysts, over the last 5 years we have performed operations in 11 children for pancreaticoduodenal pathology. The diagnoses encountered were tumors or tumor like conditions (four), angiodysplasia (one), chronic pancreatitis (one), traumatic pancreatic transection (three), traumatic pseudocyst, and neonatal hyperinsulinemic hypoglycemia (one). Operations performed were: pancreaticoduodenectomy (PD) in three patients, subtotal or distal pancreatectomy in six patients, distal pancreaticojejunostomy with oversewing of the proximal pancreatic duct in one patient, and total pancreatectomy, pancreatic cystgastrostomy, and pancreatic biopsies with biliary drainage in a single patient each. There was no operative mortality and one patient developed a pancreatic leak that resolved with drainage. Other morbidity included exocrine (n=3) and endocrine (n=2) insufficiency, intraoperative bile duct injury managed by choledochoduodenostomy (n=1), and delayed gastric emptying (n=1). Adjuvant treatment was needed in two patients for malignant tumors. Overall the children tolerated these pancreatic operations quite well.
Annals of Pediatric Surgery
Pancreas/surgery; Pancreatic Neoplasms; Pancreatitis, Chronic; Congenital Hyperinsulinism; Infant, Child; Adolescent Pancreas/injuries
Puri, V., Martin, L., St Peter, S. D., Holcomb, G. W., Ostlie, D. J. Pancreatic Operations in Children, an Institutional Experience and Review of Literature Annals of Pediatric Surgery 3, 22-30 (2007).