Postoperative complications and outcomes after pancreatic surgery in the pediatric, adolescent and young adult population

Abstract

Background: Pancreatic surgery in the pediatric, adolescent and young adult (PAYA) population is rare. Consequently, data on well-defined post-operative outcomes is scarce. The study aim was to determine the outcomes after pancreatic surgery in the PAYA population, compared to an adult population. Methods: A single center retrospective cohort study was performed including all patients who underwent pancreatic surgery between 2000 and 2016. PAYA was defined as age <35 years. All pancreatic surgery specific complications were assessed according the ISGPS guidelines and graded according to Clavien-Dindo. Outcomes in the PAYA population were compared to the adult (≥35 years) population. Results: Out of 713 patients, 35 (4.9%) were PAYA with a median (range) age of 22 (5-34) years. The 90-day mortality was 0% for PAYA group. Postoperative pancreatic fistula occurred in 22.9% of PAYA vs. 8.9% of the adult population (p=0.019). Delayed gastric emptying occurred in 22.9% of PAYA vs. 35.0% of the adult population (p=0.102). Post pancreatic hemorrhage and bile leakage did not occur in the PAYA population. Complications requiring reintervention (Clavien-Dindo grade≥3) occurred in 17.1% of the PAYA group vs. 28.0% in the adult group (p=0.227). The median time until discharge was 12.5 (9-15) in the PAYA group vs. 13 (9-20) days in the adult population (p=0.191). Conclusion: While pancreatic surgery in patients <35 years is a rarity, similar outcomes as in adults can be achieved.