Experience of performing pancreatoduodenal resection in children

Abstract

Introduction. The article is devoted to the experience of treating children with pancreatic tumors who underwent pancreatoduodenal resection (PDR) at the Department of Pediatric Surgery, Faculty of Pediatrics, N. I. Pirogov Russian National Research Medical University and at the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the N. F. Filatov Children’s City Clinical Hospital. This type of operation was performed in children with tumors of the head of the pancreas, with the spread of fibroinflammatory changes to nearby organs in chronic pancreatitis and with complicated forms of chronic duodenal obstruction. Materials and methods. For the period from 2010 to 2021 9 PDEs were performed in patients aged 1 to 16 years. The results of treatment in this category of patients were assessed as satisfactory. It is noted that the postoperative period has a number of features: prolonged restoration of gastric motility and passage through the gastrointestinal tract (100% of patients), exacerbation of chronic pancreatitis (100% of patients). Against the background of conservative therapy in all children (100% of patients), the symptoms of pancreatitis were stopped in the period from 26 to 41 postoperative days, the evacuation function of the stomach was fully restored within 2-4 weeks after the operation. Discussion and conclusions. Among the postoperative complications, there were: stenosis of biliary and pancreatic-digestive anastomoses (22% and 11% of those studied, respectively), adhesive intestinal obstruction (11% of cases), intra-abdominal bleeding (11% of patients). One patient had a lethal outcome after repeated surgical interventions for pancreatic head limphangioma complicated by intra-abdominal bleeding and biliary peritonitis. The prognosis in this category of patients is favorable - in the follow-up after surgical treatment in all children (100% of patients), the passage through the gastrointestinal tract is not disturbed, the endo- and exocrine function of the pancreas is preserved (100% of patients), there were no indications for prescribing enzyme therapy and insulin preparations …