title: Long-term follow-up of nutritional status, pancreatic function, and morphological changes of the pancreatic remnant after pancreatic tumor resection in children.
abstract: OBJECTIVE
  The objectives of the present study were to determine nutritional status, pancreatic function, and morphological changes of the pancreatic remnant after pancreatic tumor resection in children.
  
  
  METHODS
  The nutritional status was evaluated by the patterns of growth. Pancreatic function was evaluated by using a questionnaire, the Bristol stool form chart, the serum levels of fasting blood glucose, and hemoglobin A1c (HbA1c). Morphological changes of the pancreatic remnant were evaluated by computed tomography, magnetic resonance image, or magnetic resonance cholangiopancreatography.
  
  
  RESULTS
  The present study consisted of 6 patients with pancreatic tumor (5 solid pseudopapillary tumors of the pancreas and 1 pancreatoblastoma) who underwent the following operations: tumor enucleation (3), distal pancreatectomy with splenectomy (1), and pylorus-preserving pancreatoduodenectomy (PPPD [2]). The serum levels of HbA1c have been gradually elevated in 2 patients with PPPD. A significant decrease in pancreatic parenchymal thickness and dilatation of the main pancreatic duct were observed in 2 patients with PPPD.
  
  
  CONCLUSIONS
  Endocrine pancreatic insufficiency after PPPD may be explainable by obstructive pancreatitis after operation. Taking together the results of pancreatic endocrine function and morphological changes of pancreatic remnant after PPPD, tumor enucleation should be considered as surgical approach in children with pancreas head tumor whenever possible.
authors.affiliation: Department of Pediatric Surgery, Nihon University School of Medicine, Japan. sugitou.kiminobu@nihon-u.ac.jp
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Sugito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Furuya
authors.forename: Hide
authors.initials: H
authors.lastname: Kaneda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Masuko
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ohashi
authors.forename: Mikiya
authors.initials: M
authors.lastname: Inoue
authors.forename: Taro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Koshinaga
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Toshiya
authors.initials: T
authors.lastname: Maebayashi
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D010179:Pancreas / Q000473:pathology / Q000502:physiology / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D013156:Splenectomy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human