• Juri Fuchs, Martin Loos, Benedict Kinny-Köster, Thilo Hackert, Martin Schneider, Arianeb Mehrabi, Christoph Berchtold, Mohammed Al-Saeedi, Beat P Müller, Oliver Strobel, Manuel Feißt, Markus Kessler, Patrick Günther, and Markus W Büchler.
• Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
• Ann. Surg. 2024 Aug 1; 280 (2): 332339332-339.

ObjectiveThe aim of this study was to assess indications for and report outcomes of pancreatic surgery in pediatric patients.BackgroundIndications for pancreatic surgery in children are rare and data on surgical outcomes after pediatric pancreatic surgery are scarce.MethodsAll children who underwent pancreatic surgery at a tertiary hospital specializing in pancreatic surgery between 2003 and 2022 were identified from a prospectively maintained database. Indications, surgical procedures, and perioperative as well as long-term outcomes were analyzed.ResultsIn total, 73 children with a mean age of 12.8 years (range: 4 mo to 18 y) underwent pancreatic surgery during the observation period. Indications included chronic pancreatitis (n=35), pancreatic tumors (n=27), and pancreatic trauma (n=11). Distal pancreatectomy was the most frequently performed procedure (n=23), followed by pancreatoduodenectomy (n=19), duodenum-preserving pancreatic head resection (n=10), segmental pancreatic resection (n=7), total pancreatectomy (n=3), and others (n=11). Postoperative morbidity occurred in 25 patients (34.2%), including 7 cases (9.6%) with major complications (Clavien-Dindo≥III). There was no postoperative (90-d) mortality. The 5-year overall survival was 90.5%. The 5-year event-free survival of patients with chronic pancreatitis was 85.7%, and 69.0% for patients with pancreatic tumors.ConclusionThis is the largest single-center study on pediatric pancreatic surgery in a Western population. Pediatric pancreatic surgery can be performed safely. Centralization in pancreatic centers with high expertise in surgery of adult and pediatric patients is important as it both affords the benefits of pancreatic surgery experience and ensures that surgical management is adapted to the specific needs of children.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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