Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications

B.K. Pranger, J.L. van Dam, J.V. Groen, C.H. van Eijck, B.G. Koerkamp, B.A. Bonsing, J.S.D. Mieog, M.G. Besselink, O.R. Busch, G. Kazemier, K.P. de Jong, R.H.J. de Kleine, I.Q. Molenaar, M.W.J. Stommel, M.F. Gerhards, M.M.E. Coolsen, H.C. van Santvoort, E. van der Harst, J.M. Klaase, V.E. de Meijer*Dutch Pancreatic Canc Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: 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. Methods: A 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. Results: A 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. Conclusion: Pancreatic 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.
Original languageEnglish
Pages (from-to)1175-1184
Number of pages10
JournalHPB
Volume23
Issue number8
DOIs
Publication statusPublished - 1 Aug 2021

Keywords

  • INTERNATIONAL STUDY-GROUP
  • TERM-FOLLOW-UP
  • NUTRITIONAL-STATUS
  • PANCREATICODUODENECTOMY
  • OUTCOMES
  • SURGERY
  • CANCER
  • TUMOR
  • CHILDREN

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