A retrospective analysis of pancreas operations in children

Background: Operative intervention for pediatric pancreas diseases is rare. Our goal is to gain a better understanding of the indications and outcomes relating to pancreas surgery in children. We hypothesized that these operations are safe and effective in this population. Methods: With IRB approval, we performed a retrospective review of data of pediatric patients (<18 years) who underwent pancreas operations at Children's Medical Center in Dallas, Texas from January 2005 to December 2018. These procedures included distal, central and total pancreatectomy, pancreaticoduodenectomy, and lateral pancreatojejunostomy. Demographics, surgical indication, and operative and postoperative outcomes were examined. Results: Forty-six children underwent 47 pancreas operations. Pancreatic mass was the most common indication for resection (n=28, 60%), followed by traumatic injury (n=10, 21%) and chronic pancreatitis (n=8, 17%). The overall complication rate was 0.55 (range, 0-3) complications per procedure, including 4 pancreatic leaks. The overall unexpected hospital visit rate (emergency department and readmissions) was 0.76 (range, 0-6) visits per patient. There were no mortalities. Conclusions: While pancreas operations are rare procedures in children, our data demonstrate clear indications in this population with an associated low complication rate. This retrospective series highlights the role of pancreas resection in children.