Pancreatic resections for solid or cystic pancreatic masses in children.
OBJECTIVE
The aim of the study was to assess the diagnosis and management of solid pancreatic neoplasm in children and the type of surgical treatment, focusing on short- and long-term outcomes.


METHODS
We retrospectively reviewed the charts of all children who had undergone pancreatic resection for suspicion of pancreatic tumor in Kremlin Bicêtre Hospital, Paris, between 1986 and 2008. We studied the symptoms at diagnosis, the type of surgery, and the short- and long-term morbidity and mortality.


RESULTS
Of 18 patients identified, there were 7 pseudopapillary tumors, 3 neuroblastomas, 2 rhabdomyosarcomas, 1 acinar cell carcinoma, 1 endocrine cell carcinoma, 1 renal angiomyolipoma, and 3 pancreatic cysts. Symptoms at diagnosis were abdominal trauma, abdominal mass, and jaundice. Operative procedures were duodenopancreatectomy (11), mid-pancreatic resections (2), splenopancreatectomy (2), distal pancreatectomy (1), and tumorectomy (2). There were no deaths related to surgery. The postoperative morbidity rate was 45%, including 2 cases of fistula (11%) occurring after a mid-pancreatic resection and a pancreaticoduodenectomy. The median follow-up was 4.2 years (range 2-11). There was no diabetes mellitus, but there was 1 case of fat diet intolerance requiring pancreatic enzyme substitution. All of the children had a growth curve within normal limits.


CONCLUSIONS
In this experience, pancreatic resections have proven to be a safe and efficient procedure, with low long-term morbidity, for the treatment of tumoral and selected nontumoral pancreatic masses.
Department of Pediatric Surgery, Bicêtre Hospital, Le Kremlin Bicêtre, France. cessolivia@gmail.com
C O
CO
Muller
F
F
Guérin
D
D
Goldzmidt
V
V
Fouquet
S
S
Franchi-Abella
M
M
Fabre
S
S
Branchereau
H
H
Martelli
F
F
Gauthier
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D008297:Male; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy; D010181:Pancreatic Cyst / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010297:Paris / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D016896:Treatment Outcome