Laparoscopic Resection of Pancreatic Tumors in Children: Results of a Multicentric Survey

Autor: Alessandro Settimi, François Becmeur, David C. van der Zee, George W. Holcomb, Maria Escolino, Amulya Saxena, Pascal De Lagausie, Ciro Esposito
Přispěvatelé: Esposito, Ciro, De Lagausie, Pascal, Escolino, Maria, Saxena, Amulya, Holcomb, George W, Settimi, Alessandro, Becmeur, Francoi, van der Zee, David
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Abdominal pain
Adolescent
Vomiting
medicine.medical_treatment
Operative Time
03 medical and health sciences
0302 clinical medicine
Pancreatectomy
Postoperative Complications
children
Pancreatic tumor
Pancreaticojejunostomy
Positron Emission Tomography Computed Tomography
Surveys and Questionnaires
Pediatric surgery
medicine
Humans
resection
Child
Insulinoma
Retrospective Studies
Ultrasonography
medicine.diagnostic_test
business.industry
Infant
Retrospective cohort study
MIS
medicine.disease
Hypoglycemia
Surgery
Abdominal Pain
Pancreatic Neoplasms
Positron emission tomography
030220 oncology & carcinogenesis
Child
Preschool
Congenital hyperinsulinism
pancreatic tumor
030211 gastroenterology & hepatology
Congenital Hyperinsulinism
Female
Laparoscopy
medicine.symptom
Pancreatic Cyst
business
Zdroj: Journal of laparoendoscopicadvanced surgical techniques. Part A. 27(5)
ISSN: 1557-9034
Popis: AIM: This study aimed to report the results of a multicentric survey about laparoscopic treatment of pancreatic tumors in children. MATERIALS AND METHODS: The data of patients operated using minimally invasive surgery (MIS) for a pancreatic tumor in 5 International centers of Pediatric Surgery in the last 5 years were retrospectively reviewed. We recorded data relating to the clinical presentation, diagnostic evaluation, surgical technique, and outcome. RESULTS: Fifteen patients (average age 2.2 years) were identified. The most common symptoms at presentation were related to the hypoglycemic hyperinsulinism, followed by abdominal pain and vomiting. Tumor types were insulinoma (n = 4), congenital hyperinsulinism of infancy (CHI) diffuse type (n = 3), CHI focal type (n = 3), solid pseudopapillary tumor (n = 2), and cystic malformation (n = 3). The diagnostic assessment was completed using ultrasound associated with computed tomography (CT) scan in all centers; 18FDOPA positron emission tomography in combination with CT was adopted in 2 centers. The MIS procedures performed were as follows: tumor enucleation (n = 4), distal pancreatectomy (n = 8), subtotal pancreatectomy (n = 2), and pancreatico-jejunostomy (n = 1). Average operative time was 110 minutes. As for postoperative complications, we recorded 1 persistent hypoglycemia, requiring redo-surgery (IIIb Clavien-Dindo) and 1 thrombosis of splenic vein, not requiring any treatment (I Clavien-Dindo). CONCLUSIONS: Laparoscopic resection can be considered a safe and effective treatment with minimal morbidity and excellent outcomes for most pediatric pancreatic tumors. Suspension of the stomach with a transparietal stitch and use of new hemostatic devices as Starion TLS3 or Ligasure are key factors for the success of the procedure. A long-term follow-up is mandatory in these patients to evaluate postoperative complications and long-term outcome.
Databáze: OpenAIRE
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