Potential of endovideosurgery in the treatment of children with focal pancreatic lesions

Abstract

   Aim. To evaluate the effectiveness of laparoscopic surgeries for diseases and malformations of the pancreas in children.   Materials and methods. 53 laparoscopies were performed from 2005 to 2023. Enucleation was performed in 16 children, distal resection of the pancreas with spleen preservation – in 16, corpo-caudal resection of the pancreas – in 4, subtotal resection of the pancreas – in 9, central resection of the pancreas – in 5, head resection with duodenal preservation – in 1, pancreaticoduodenal resection with pyloric preservation – in 2 children. The age of the children ranged from 2 months to 17 years.   Results. All surgeries have achieved the intended clinical effect. The average time of enucleation accounted for 88.1 ± 47.7 min., distal resection with spleen preservation – 100.3 ± 21 min., corpo-caudal resection – 113.3 ± 28.9min., subtotal resection – 101 ± 21.7 min., central resection – 243.3 ± 81.1 min., head resection with duodenal preservation – 235 min., pancreaticoduodenal resection with pyloric preservation – laparoscopic and laparoscopically assisted – 435 and 415 min. Intraoperative bleeding was noted in 6 cases (11.3 %), in 2 (3.8 %) conversion was performed in 2 cases (3.8 %). The postoperative period revealed 6 (13.2 %) early and 8 (15.1 %) late complications. No fatal outcomes reported. The follow-up ranged from 1 to 10 years, no recurrences reported.   Conclusion. Focal pancreatic lesions in children refer to heterogeneous diseases and malformations requiring various resection interventions. Laparoscopic enucleation and distal resection of the pancreas are considered as the most effective. Further clinical experience is required to explore the feasibility of using laparoscopy in children to perform central resection of the pancreas and pancreaticoduodenectomy.