[Clinical diagnosis and treatment characteristics of pancreatic cystic neoplasms in pediatric patients: a report of 13 cases]

H F Kuang, X Q Yan, X F Duan, H Q Bian, J Yang, Z C Zhu
Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery] 2020 July 1, 58 (7): 525-529
Objective: To investigate the clinical characteristics of pancreatic cystic neoplasms in pediatric patients. Methods: The clinical data of 13 patients with pancreatic cystic neoplasm at Wuhan Children's Hospital from July 2007 to November 2019 were collected.There were 5 males and 8 females, with a mean age of 133 months(range: 9 to 170 months). Eleven patients presented with abdominal pain, vomiting, and a palpable mass. Tumors were located in the pancreatic head( n= 7), body( n= 2) and tail( n= 4), respectively. Results: The preoperative diagnosis was confirmed by imaging examination in 11 patients, CT and MRI was significantly superior to ultrasound in the exact diagnosis of the tumor types. In this group, surgical methods mainly included pancreaticoduodenectomy( n= 3), pylorus-preserving pancreatoduodenectomy( n= 1), duodenum-preserving pancreas head resection( n= 3), spleen-preserving distal pancreatectomy ( n= 3), distal pancreatectomy plus splenectomy( n= 2), and tumor enucleation( n= 1). Postoperative complications including biochemical leakage( n= 1), delayed gastric emptying(grade A) ( n= 1), adhesive intestinal obstruction( n= 1), transient elevation of platelet count( n= 2), all were cured by conservative treatment. In one patient biliary leakage occurred and later developed into biliary stricture, this patient underwent the second operation 6 weeks later and recovered smoothly. All patients were diagnosed by postoperative pathology, including solid pseudopapillary neoplasm( n= 10), serous cystadenoma( n= 1), mucinous cystadenoma( n= 1) and cystic lymphangiom( n= 1). Three cases were lost in this group, the rest of patients were all accepted outpatient or telephones follow-up. There was no evidence of recurrence or metastasis during 3 to 92 months follow-up. Conclusions: The incidence of pancreatic cystic neoplasm is low in the pediatric patients. Symptomatic patients should receive surgical treatment timely. It's safe and effective to choose the organs and functions-preserving surgical method.

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