Original Article

Radical resection of the pancreas should not always be necessary in the surgical management of pancreatic solid pseudopapillary tumor in children

Volume 28 · Issue 3 · May 2017 Publish Date: May 15, 2017
Emre Divarcı 1 Zafer Dökümcü 2 Nazan Çetingül 3 Deniz Nart 4 Funda Yılmaz Barbet 5 Orkan Ergün 6 Ahmet Çelik 7
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Turkish Journal of Gastroenterology

Volume 28 · Issue 3 · May 2017

Pages: 214-218

History

Published Online: May 15, 2017

Copyright © 2017 Emre Divarcı, Zafer Dökümcü, Nazan Çetingül, Deniz Nart, Funda Yılmaz Barbet, Orkan Ergün, Ahmet Çelik

Emre Divarcı
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
Zafer Dökümcü
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
Nazan Çetingül
Department of Pediatric Oncology, Ege University School of Medicine, İzmir, Turkey
Deniz Nart
Departments of Pathology, Ege University School of Medicine, İzmir
Funda Yılmaz Barbet
Department of Pathology, Ege University School of Medicine, İzmir, Turkey
Orkan Ergün
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
Ahmet Çelik
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
Divarcı, E., Dökümcü, Z., Çetingül, N., Nart, D., Yılmaz Barbet, F., Ergün, O., & Çelik, A. (2017). Radical resection of the pancreas should not always be necessary in the surgical management of pancreatic solid pseudopapillary tumor in children. Turkish Journal of Gastroenterology, 28(3), 214–218. https://doi.org/10.5152/tjg.2017.16713
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Abstract

Abstract Background/Aims: Pancreatic solid pseudopapillary tumor (SPT) is a rare neoplasm in children. In this study, we aimed to present our surgical strategy based on minimal resection by enucleation or limited resection in localized pancreatic SPT. Materials and Methods: We retrospectively analyzed the medical records of children who underwent surgical resection between October 2011 and September 2016. Results: Five female patients with a median age of 15 years (range, 14-17 years) were operated. Tumors were located in the pancreatic head (n=4) or tail (n=1). The median greatest tumor diameter was 9 cm (range, 5-13 cm). All the patients were investigated with MRI before the resection to demonstrate the relationship between the tumor and the main pancreatic duct. Patients underwent enucleation (n=4) for head localization or local distal resection without splenectomy (n=1) at the pancreatic tail. At postoperative follow-up, major pancreatic leakage was observed in two patients and endoscopically treated. Surgical margins were negative in all patients. The median follow-up period was 44 months (range, 2-59 months) and no local recurrence or distant metastasis was observed in the postoperative period. Conclusion: An optimal surgical strategy is still controversial in pancreatic SPT in children. Radical resections such as pancreaticoduodenoctomy or distal pancreatectomy with splenectomy result in loss of pancreatic tissue for endocrine and exocrine functions. Minimal resections such as enucleation or limited pancreatic resection with negative surgical margins should be performed in selected patients with no invasion to the main pancreatic duct or adjacent organs.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 28 · Issue 3 · May 2017
Pages 214-218
DOI 10.5152/tjg.2017.16713
History
Published Online May 15, 2017
Copyright
Copyright (c) 2017 Emre Divarcı, Zafer Dökümcü, Nazan Çetingül, Deniz Nart, Funda Yılmaz Barbet, Orkan Ergün, Ahmet Çelik
Affiliations
1
Emre Divarcı
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
2
Zafer Dökümcü
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
3
Nazan Çetingül
Department of Pediatric Oncology, Ege University School of Medicine, İzmir, Turkey
4
Deniz Nart
Departments of Pathology, Ege University School of Medicine, İzmir
5
Funda Yılmaz Barbet
Department of Pathology, Ege University School of Medicine, İzmir, Turkey
6
Orkan Ergün
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
7
Ahmet Çelik
Department of Pediatric Surgery, Ege University School of Medicine, İzmir, Turkey
Cite this Article
Divarcı, E., Dökümcü, Z., Çetingül, N., Nart, D., Yılmaz Barbet, F., Ergün, O., & Çelik, A. (2017). Radical resection of the pancreas should not always be necessary in the surgical management of pancreatic solid pseudopapillary tumor in children. Turkish Journal of Gastroenterology, 28(3), 214–218. https://doi.org/10.5152/tjg.2017.16713
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