Laparoscopic Pancreatic Resections for Solid Pseudopapillary Tumor in Children

Abstract

Introduction: The aim of this study is to investigate the effectiveness of laparoscopic pancreatic resections for solid pseudopapillary tumors (SPT) in children. Patients and methods: Two 13-year-old girls suffered from recurrent episodes of abdominal pain. Ultrasound and CT revealed a well-circumscribed heterogeneous mass arising from the neck of the pancreas in one and a solid homogeneous tumor with small cystic areas in the pancreatic tail in the other. Both patients underwent laparoscopic procedures. In the first case, after resection of the tumor a two-layer anastomosis between the distal pancreatic body and the posterior gastric wall was performed. In the second case, a spleen-preserving distal pancreatectomy was carried out. Histopathological examinations demonstrated SPT of the pancreas in both cases. Results: Both procedures were completed laparoscopically. The operation times were 240 min and 150 min, respectively. The suction drains were removed on 7th postoperative day. Realimentation was started on day 5. The postoperative course was uneventful. Control CT scans at 6 months and 2 years were normal. Conclusions: 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.