Laparoscopic Pancreatic Resections for Solid Pseudopapillary Tumor in Children

Abstract

As experience with minimally invasive techniques continues to grow, laparoscopic pancreatic resections appear to be safe and feasible in children with SPT. Laparoscopic central pancreatectomy with distal pancreaticogastrostomy can be used to treat tumors of the middle pancreas. For tumors located in the pancreatic tail, laparoscopic spleen-preserving distal pancreatectomy may well become the approach of choice.

Pancreatic tumours in children: diagnosis, treatment and outcome

“…A laparoscopic approach to paediatric pancreatic tumours has been previously reported and was also adopted in our series [19]. Laparoscopic central pancreatectomy with distal pancreaticogastrostomy has been shown to be safe for tumours affecting the body of the pancreas [20]. For lesions located in the pancreatic tail, laparoscopic distal pancreatectomy with preservation of the spleen seems to be the preferred surgical approach over open surgery [20].…”

“…Laparoscopic central pancreatectomy with distal pancreaticogastrostomy has been shown to be safe for tumours affecting the body of the pancreas [20]. For lesions located in the pancreatic tail, laparoscopic distal pancreatectomy with preservation of the spleen seems to be the preferred surgical approach over open surgery [20]. For benign or low-grade malignant lesions located in the head of the pancreas, duodenum-preserving pancreatic head resection has been shown to have favourable outcomes in adults in terms of post-operative complications, pancreatic function and recurrence [21].…”

Central pancreatectomy for pancreatoblastoma in a 16-year-old girl

“…Nevertheless, despite any proved advantages and more adult patients with CP, this conservative pancreatic surgical procedure is extremely rare reported in children either by open [12] or laparoscopic approach [13]. The indications for CP in the reported cases were solid pseudopapillary tumor (2 patients) and pancreatic trauma (one patient) [12,13].…”

Laparoscopic and Computer-Assisted Surgery in Children

“…The indications include insulinoma and congenital hyperinsulinism (47,48) and pancreatic trauma (49). The role of laparoscopic techniques for resection of pancreatic pseudopapillary tumor is very controversial as it has been reported to be a feasible alternative to open surgery (50,51), but seems to increase the risk of tumor recurrence compared to open surgery (51). For none of the indications, randomized trials have been published, comparing the results to open surgery, so no general recommendation can be given.…”