Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center
Purpose: Whipple's pancreaticoduodenectomy (WPD) is rarely required in children. However, WPD is the only option with pathologies involving the head of the pancreas requiring surgical excision. The objective of our study was to review our experience with WPD performed on children. Materials and...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Indian Association of Pediatric Surgeons |
| Subjects: | |
| Online Access: | http://www.jiaps.com/article.asp?issn=0971-9261;year=2018;volume=23;issue=4;spage=212;epage=215;aulast=Varshney |
| _version_ | 1819198425105694720 |
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| author | Abhimanyu Varshney Anjan Kumar Dhua Vishesh Jain Sandeep Agarwala Veereshwar Bhatnagar |
| author_facet | Abhimanyu Varshney Anjan Kumar Dhua Vishesh Jain Sandeep Agarwala Veereshwar Bhatnagar |
| author_sort | Abhimanyu Varshney |
| collection | DOAJ |
| description | Purpose: Whipple's pancreaticoduodenectomy (WPD) is rarely required in children. However, WPD is the only option with pathologies involving the head of the pancreas requiring surgical excision. The objective of our study was to review our experience with WPD performed on children.
Materials and Methods: A retrospective analysis of case records was conducted on all patients <18 years of age, who underwent WPD at our center over the last 20 years. Data regarding demographics, signs, and symptoms at presentation, diagnostic imaging and procedures, pathologic reports, surgical and medical treatment, and follow-up were collected to study the indications and safety and outcomes of WPD in children.
Results: Five patients had been planned for a WPD during the study (1995–2015); but in one patient, the procedure was abandoned, the rest four patients formed the study group. Male to female ratio was 3:1. Median age at the time of surgery was 9 years (11 months–12 years). The most common presentation was obstructive jaundice (50%, 2/4). Radiological imaging was able to accurately predict the surgical procedure required in all except one case. The mean operating time was 205 min (180–240 min). There were no intraoperative complications. The mean intraoperative blood loss was 85 mL (20–150 mL). The youngest patient requiring WPD was an 11-month-old child. Oral feeding was established by the 7th postoperative day (range 5–7 days) in all cases. There were no cases of anastomotic leak or pancreatic or jejunal fistulae. One patient developed features of subacute intestinal obstruction after discharge and required re-exploration. There was no intra- or post-operative mortality.
Conclusion: WPD is safe and efficacious procedure in a selected group of children. The overall efficacy of surgical treatment combined with the relatively low severity of complications leads us to recommend WPD in children when indicated. |
| first_indexed | 2024-12-23T03:00:14Z |
| format | Article |
| id | doaj.art-b4cce4e7d91e4e1abc5a99fc202efb2c |
| institution | Directory Open Access Journal |
| issn | 0971-9261 1998-3891 |
| language | English |
| last_indexed | 2024-12-23T03:00:14Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian Association of Pediatric Surgeons |
| spelling | doaj.art-b4cce4e7d91e4e1abc5a99fc202efb2c2022-12-21T18:02:27ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912018-01-0123421221510.4103/jiaps.JIAPS_35_18Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care centerAbhimanyu VarshneyAnjan Kumar DhuaVishesh JainSandeep AgarwalaVeereshwar BhatnagarPurpose: Whipple's pancreaticoduodenectomy (WPD) is rarely required in children. However, WPD is the only option with pathologies involving the head of the pancreas requiring surgical excision. The objective of our study was to review our experience with WPD performed on children. Materials and Methods: A retrospective analysis of case records was conducted on all patients <18 years of age, who underwent WPD at our center over the last 20 years. Data regarding demographics, signs, and symptoms at presentation, diagnostic imaging and procedures, pathologic reports, surgical and medical treatment, and follow-up were collected to study the indications and safety and outcomes of WPD in children. Results: Five patients had been planned for a WPD during the study (1995–2015); but in one patient, the procedure was abandoned, the rest four patients formed the study group. Male to female ratio was 3:1. Median age at the time of surgery was 9 years (11 months–12 years). The most common presentation was obstructive jaundice (50%, 2/4). Radiological imaging was able to accurately predict the surgical procedure required in all except one case. The mean operating time was 205 min (180–240 min). There were no intraoperative complications. The mean intraoperative blood loss was 85 mL (20–150 mL). The youngest patient requiring WPD was an 11-month-old child. Oral feeding was established by the 7th postoperative day (range 5–7 days) in all cases. There were no cases of anastomotic leak or pancreatic or jejunal fistulae. One patient developed features of subacute intestinal obstruction after discharge and required re-exploration. There was no intra- or post-operative mortality. Conclusion: WPD is safe and efficacious procedure in a selected group of children. The overall efficacy of surgical treatment combined with the relatively low severity of complications leads us to recommend WPD in children when indicated.http://www.jiaps.com/article.asp?issn=0971-9261;year=2018;volume=23;issue=4;spage=212;epage=215;aulast=VarshneyPancreatoblastomasolid pseudopapillary epithelial neoplasmWhipple's pancreatoduodenectomy |
| spellingShingle | Abhimanyu Varshney Anjan Kumar Dhua Vishesh Jain Sandeep Agarwala Veereshwar Bhatnagar Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center Journal of Indian Association of Pediatric Surgeons Pancreatoblastoma solid pseudopapillary epithelial neoplasm Whipple's pancreatoduodenectomy |
| title | Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center |
| title_full | Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center |
| title_fullStr | Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center |
| title_full_unstemmed | Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center |
| title_short | Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center |
| title_sort | whipple s pancreaticoduodenectomy in pediatric patients an experience from a tertiary care center |
| topic | Pancreatoblastoma solid pseudopapillary epithelial neoplasm Whipple's pancreatoduodenectomy |
| url | http://www.jiaps.com/article.asp?issn=0971-9261;year=2018;volume=23;issue=4;spage=212;epage=215;aulast=Varshney |
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