Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
HPB (Oxford). 2020 Feb;22(2):306-311. doi: 10.1016/j.hpb.2019.06.009. Epub 2019 Aug 10.
To investigate the safety, feasibility, and complications of using duodenum-preserving pancreas head resection (DPPHR) to treat pediatric benign and low-grade malignant pancreatic head tumors.
Patients with pancreatic head tumors that underwent resection were retrospectively analyzed for perioperative factors and postoperative complications.
Thirty-five patients with a median age of 10 years at diagnosis were identified. Patients were divided by procedures into the DPPHR (n = 22), local enucleation (n = 7) and pylorus-preserving pancreatoduodenectomy (PPPD, n = 6) groups. No significant difference was found in operation time between the DPPHR and PPPD groups (P > 0.05). Significantly, longer drainage time, duration of somatostatin use and hospital stay were observed in the DPPHR group than in the PPPD group (P < 0.05). The incidences of short-term complications were not significantly different among the three groups (P > 0.05). The incidence of long-term complications was markedly lower in both the DPPHR and local enucleation groups than in the PPPD group (P < 0.05).
DPPHR might be a safe treatment option for pediatric patients with benign and low-grade malignant pancreatic head tumors. The incidence of long-term complications was significantly lower with DPPHR. However, perioperative management might be challenging for surgeons.
研究使用保留十二指肠胰头切除术（DPPHR）治疗儿科良性和低度恶性胰头肿瘤的安全性、可行性和并发症。
对接受胰头肿瘤切除术的患者进行围手术期因素和术后并发症的回顾性分析。
共纳入 35 例诊断时中位年龄为 10 岁的患者。根据手术方式将患者分为 DPPHR 组（n=22）、局部剜除组（n=7）和保留幽门胰十二指肠切除术（PPPD）组（n=6）。DPPHR 组与 PPPD 组的手术时间无显著差异（P>0.05）。DPPHR 组的引流时间、生长抑素使用时间和住院时间明显长于 PPPD 组（P<0.05）。三组短期并发症的发生率无显著差异（P>0.05）。DPPHR 组和局部剜除组的长期并发症发生率明显低于 PPPD 组（P<0.05）。
DPPHR 可能是治疗儿科良性和低度恶性胰头肿瘤患者的安全选择。DPPHR 的长期并发症发生率显著降低。然而，对于外科医生来说，围手术期管理可能具有挑战性。
