Long-term outcome of pancreatic function following oncological surgery in children:Institutional experience and review of the literature  

作　　者：Giulia Bolasco Teresa Capriati Chiara Grimaldi Lidia Monti Maria Debora De Pasquale Ippolita Patrizia Patera Marco Spada Giuseppe Maggiore Antonella Diamanti 

机构地区：[1]Hepatology,Gastroenterology and Nutrition Unit,“Bambino Gesù”Children’s Hospital,IRCCS,Rome 00165,Italy [2]Division of Hepatobiliopancreatic Surgery,Liver and Kidney Transplantation,"Bambino Gesù"Children's Hospital,IRCCS,Rome 00165,Italy [3]Radiology Department,"Bambino Gesù"Children’s Hospital,IRCCS,Rome 00165,Italy [4]Hematology/Oncology Department,"Bambino Gesu"Children's Hospital,IRCCS,Rome 00165,Italy [5]Endocrinology and Diabetes Unit,"Bambino Gesù"Children’s Hospital,IRCCS,Rome 00165,Italy

出　　处：《World Journal of Clinical Cases》2021年第25期7340-7349,共10页世界临床病例杂志

摘　　要：BACKGROUND Pancreatic neoplasms are uncommon in children and in most cases they are benign or have low malignant potential.Pancreatoblastoma and solid pseudopapillary tumor are the most frequent types in early and late childhood,respectively.Complete resection,although burdened by severe complications,is the only curative treatment for these diseases.Pancreatic surgery may result in impaired exocrine and endocrine pancreatic function.However,limited data are available on the long-term pediatric pancreatic function following surgical resection.AIM To investigate endocrine and exocrine pancreatic function and growth after oncological pancreatic surgery in a pediatric series.METHODS A retrospective analysis of all pediatric patients who underwent surgery for pancreatic neoplasm in our Institution from January 31,2002 to the present was performed.Endocrine and exocrine insufficiency,auxological and fat-soluble vitamin status(A,D,E and clotting tests)were assessed at diagnosis and at every follow-up visit.Exocrine insufficiency was defined as steatorrhea with fecal elastase-1<200μg/g stool,while endocrine insufficiency was identified as onset of Diabetes or Impaired Glucose Tolerance.Growth was evaluated based on body mass index(BMI)z-score trend.RESULTS Sixteen patients(12 girls and 4 boys,mean age 10.7±5.3 years),were included.Nine patients(56%)had a neoplasm in the pancreatic head,4 in the body/tail,2 in the tail and 1 in the body.Histological findings were as follows:Solid pseudopapillary tumor in 10 patients(62.5%),insulinoma in 2 patients,neuroendocrine tumor in 2 patients and acinar cell carcinoma in 2 patients.The most frequent surgery was pancreaticoduodenectomy(50%).Exocrine failure occurred in 4 patients(25%)and endocrine failure in 2 patients(12.5%).Exocrine insufficiency occurred early(within 6 mo after surgery)and endocrine insufficiency later(8 and 10 years after surgery).Mean BMI z-score was 0.36±1.1 at diagnosis and 0.27±0.95 at the last assessment.Vitamin D was insufficient(<30 ng/mL)in 8 of the

关 键 词：Pancreatic neoplasms Pancreatic function CHILDREN MALABSORPTION Pancreatic failure Growth 

分 类 号：R735.9[医药卫生—肿瘤]