Laparoscopic Pancreas Surgery for Solid Pseudopapillary Tumor in Children

Jung-Man Namgoong, MD, Dae-Yeon Kim, MD, PhD, Song-Cheol Kim, MD, PhD, Seong-Chul Kim, MD, PhD, Ki-Byung Song, MD, PhD, Ji-Hee Hwang, MD. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Solid pseudopapillary tumor (SPT) of the pancreas is rare primary neoplasm of the pancreas with malignant potential, but an excellent prognosis. The aim of this study was to evaluate the outcome of laparoscopic pancreas surgery for SPT in children.

Methods: A retrospective review was conducted for patients under the age of 18 years old who had undergone laparoscopic pancreas surgery for pathologically confirmed SPT between January 2006 and December 2012.

Results: 20 patients underwent laparoscopic pancreas surgery for SPT. The patient group comprised 17 females and 3 males, with a mean age of 14.7±2.8 months. They underwent laparoscopic distal pancreatectomy [LDP (n=14)], laparoscopic pancreaticoduodenectomy [LPPPD (n=2)], laparoscopic central pancreatectomy [LCP (n=1)] and laparoscopic enucleation of pancreas [LEP (n=3)]. 71.4% of the LDP performed were spleen-sparing LDP (SSLDP) included 2 cases of splenic vessel sacrificing SSLDP (Warshow technique) and Single port SSLDP. Mean duration of surgery was 229.8±145.5 minutes and one patient was performed transfusion. There was one conversion to open procedure in the patients group. Perioperative mortality was not developed, but 9 patients were involved postoperative complications included pancreatic fistula (n=7), fluid collection (n=3), splenic infarct (n=3) and wound seroma (n=1). There was no grade C pancreatic fistula. Recurrence of tumor was shown in one patient who underwent LEP due to incomplete resection.

Conclusion: Lately, laparoscopic surgery is being used more and more extensively in pediatric population, and its scope of usage has widened to include pancreas surgery. The prognosis of laparoscopic surgical treatment for SPT was good in pediatric patients. Because SPT is the rare, but most common pancreas tumor in children and malignancy of pancreas is extremely rare in children. Laparoscopic pancreas surgery, therefore, would be a safe and feasible option for STP in children. Key words:solid pseudopapillary tumor, laparoscopic pancreas surgery, laparoscopic pancreatectomy, laparoscopic distal pancreatectomy

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