Abstract
BackgroundThe aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. MethodsA nationwide retrospective cohort study was performed in PAYA patients who underwent pancreatic resection between 2007 and 2016. PAYA was defined as all patients <40 years at time of surgery. Pancreatic surgery-specific complications were assessed according to international definitions and textbook outcome was determined. ResultsA total of 230 patients were included in the PAYA cohort (112 distal pancreatectomies, 99 pancreatoduodenectomies), and 2526 patients in the comparator cohort. For pancreatoduodenectomy, severe morbidity (29.3% vs. 28.6%; P = 0.881), in-hospital mortality (1% vs. 4%; P = 0.179) and textbook outcome (62% vs. 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were also similar for distal pancreatectomy. After pancreatoduodenectomy, new-onset diabetes mellitus (8% vs. 16%) and exocrine pancreatic insufficiency (27% vs. 73%) were lower in the PAYA cohort when compared to adult literature. ConclusionPancreatic surgery-specific complications were comparable with patients ≥40 years. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, however, was substantially lower compared to adult literature.
Highlights
Pancreatic resection in the pediatric, adolescent and young adult (PAYA) population is uncommon
Patient characteristics The PAYA cohort comprised of 230 patients
The comparator cohort initially comprised of 2586 patients, of which 60 patients were excluded from analysis because essential data on the surgical procedure or outcomes were lacking
Summary
Pancreatic resection in the pediatric, adolescent and young adult (PAYA) population is uncommon. The aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. Severe morbidity (29.3% vs 28.6%; P = 0.881), in-hospital mortality (1% vs 4%; P = 0.179) and textbook outcome (62% vs 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were similar for distal pancreatectomy. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, was substantially lower compared to adult literature
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