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

Dutch Pancreatic Cancer Group, Bobby K Pranger, Jacob L van Dam, Jesse V Groen, Casper H van Eijck, Bas G Koerkamp, Bert A Bonsing, J Sven D Mieog, Marc G Besselink, Olivier R Busch, Geert Kazemier, Koert P de Jong, Ruben H J de Kleine, I Quintus Molenaar, Martijn W J Stommel, Michael F Gerhards, Marielle M E Coolsen, Hjalmar C van Santvoort, Erwin van der Harst, Joost M KlaaseVincent E de Meijer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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
JournalHpb
Early online date3-Dec-2020
DOIs
Publication statusE-pub ahead of print - 3-Dec-2020

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