Duodenum-Sparing Technique of Head Resection in Solid Pseudopapillary Tumor of the Pancreas in Children

Šnajdauf, J; Rygl, Michal; Petrů, O; Kalousová, J; Kuklova, P; Mixa, Vladimír; Keil, Radan; Hříbal, Z.

doi:10.1055/s-0029-1237729

Cited by 19 publications

(5 citation statements)

References 12 publications

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“…18,19 Surgery is the cornerstone of treatment for SPPT of pancreas, with a good prognosis expected after radical resection of the primary lesion. [3][4][5][6]8,[20][21][22][23] Distant metastases are present in 5% to 20% 24,25 of adult cases at initial presentation, while in children the rate is lower than 5%. 4 as confirmed in the present series (one metastatic patient out of 43).…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Local recurrence and metastases are rare and often reported after incomplete resection, as well as expression of intrinsic malignancy of the tumor. [2][3][4] As a matter of fact, data on postoperative management and complications are scant [4][5][6][7][8] in pediatric series: this paper focuses on surgical outcomes of pancreatic resections for SPPT, reporting the Italian experience of pancreatic resections for SPPT in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

Crocoli

Grimaldi

Virgone

et al. 2018

Pediatric Blood & Cancer

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Background Solid pseudopapillary pancreatic tumors (SPPT) are an extremely rare entity in pediatric patients. Even if the role of radical surgical resection as primary treatment is well established, data about follow‐up after pancreatic resection in children are scant. Methods A retrospective review of data from the Italian Pediatric Rare Tumor Registry (TREP) was performed. Short‐term (<30 days) and long‐term complications of different surgical resections, as well as long‐term follow‐up were evaluated. Results From January 2000 to present, 43 patients (male:female = 8:35) were enrolled. The median age at diagnosis was 13.2 years (range, 7–18). Nine children had an incidental diagnosis, whereas 26 complained of abdominal pain and 4 of palpable mass. Tumors arose either from the head of pancreas (n = 14) or from body/tail (n = 29): only one patient presented with metastatic disease. Resection was complete in all patients (cephalic duodenopancreatectomy vs distal resection). At follow‐up (median, 8.4 years; range, 0–17 years), one recurrence occurred in a patient with intraoperative rupture. All patients are alive. Three pancreatic fistulas occurred in the body/tail group, whereas four complications occurred in the head group (one ileal ischemia, two stenosis of the pancreatic duct, and one chylous fistula). Conclusion Surgery is the best therapeutic option for these tumors; hence, complete resection is mandatory. Extensive resections, including cephalic duodenopancreatectomy, are safe when performed in specialized centers. Long‐term follow‐up should be aimed to detect tumor recurrence and to evaluate residual pancreatic function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

Crocoli

Grimaldi

Virgone

et al. 2018

Pediatric Blood & Cancer

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“…The CUSA has been previously reported to be of benefit in pancreatic tumor resections especially those tumors located on the head of the pancreas. 13,14 In performing a 98% pancreatectomy, our dissection would start in a conventional manner at the tail of the pancreas moving toward the head. The spleen is preserved by ligating the small splenic vein branches to the pancreas.…”

Section: Discussionmentioning

confidence: 99%

Cavitron Ultrasonic Surgical Aspirator-Assisted Pancreatic Resection in Hyperinsulinism

et al. 2017

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Introduction Diffuse congenital hyperinsulinemia continues to be poorly responsive to medical management. Surgical resection for this entity can be variable in extent and efficacy. Materials and Methods This report describes a unique method of pancreatic resection for diffuse familial congenital hyperinsulinemia. The procedure maximizes pancreatic parenchymal removal while preserving blood supply to the vital structures adjacent to the head of the pancreas. Two cases of familial congenital hyperinsulinism are presented as well as a review of the current surgical literature. Results The Cavitron ultrasonic surgical aspirator has been used successfully to assist in maximum resection of pancreatic tissue while preserving blood supply to the duodenum and common bile duct. Conclusion This report describes a useful technique of maximizing pancreatic resection for patients with diffuse congenital hyperinsulinemia which preserves adjacent vital structures.

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“…Is there evidence of an infi ltration of the duodenum, -the choledochal duct, the porta hepatis, the caval vein, or the superior mesenteric vessels? If the tumor seems to be resectable, it should be removed totally even without knowledge of the histological diagnosis (Perez et al 2009 ;Snajdauf et al 2009 ) . Open biopsy should only be performed in all cases that would necessitate extended surgery (e.g., partial duodenopancreatectomy) for complete resection.…”

Section: Surgical Approachmentioning

confidence: 99%

Pancreatic Tumors

Barthlen

Brecht

Sipos

2011

Rare Tumors in Children and Adolescents

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Duodenum-Sparing Technique of Head Resection in Solid Pseudopapillary Tumor of the Pancreas in Children

Cited by 19 publications

References 12 publications

Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

Cavitron Ultrasonic Surgical Aspirator-Assisted Pancreatic Resection in Hyperinsulinism

Pancreatic Tumors

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