WOFAPS 2025 8th World Congress of Pediatric Surgery

Kübra Öztürk Yüzdemir, Gizem Korkmaz, İdil Rana User, Burak Ardıçlı, İbrahim Karnak, Arbay Özden Çiftçi, Saniye Ekinci

Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye

Introduction: Pancreatic surgery in pediatric population is rare and technically demanding,

with limited data on indications, surgical techniques, and outcomes. This study presents a

ten-year, single-center experience to describe the indications, procedures and postoperative

outcomes of pancreatic surgery in children.

Methods: A retrospective review was conducted in patients who underwent pancreatic

surgery by the same pediatric surgeons over the past decade. Data collected included

demographics, surgical indications, operative details, pathological findings and outcomes.

Results: A total of 23 patients (12 males, 11 females) with the median age of 12 years

underwent pancreatic surgery. Indications were pancreatic tumors (n=15), chronic

pancreatitis (n=3), nesidioblastosis/hyperinsulinism (n=3), and metastatic/infiltrative tumors

(n=2). Procedures performed were subtotal or distal pancreatectomy (n=17), Whipple

procedure (n=3), and pancreaticojejunostomy (n=3). Splenectomy was performed in two

patients—one with hereditary pancreatitis and peripancreatic inflammation obscuring

splenic vessels, and one with desmoid fibromatosis involving pancreatic tail and splenic

hilum. All patients had surgical drains with a median duration of 10 (7–13) days.

Postoperative complications occurred in 17 patients, including pancreatic leak (n=8), wound

infection (n=5), intra-abdominal collections (n=2), intestinal perforation (n=1), and ileus

(n=1). Octreotide infusion was administered to all patients with pancreatic leaks. One

patient with a persistent leak underwent endoscopic pancreatic duct stenting. Percutaneous

drainage was used in two patients, and re-laparotomy was performed in two cases with

intestinal obstruction. Median time to enteral feeding was 5 (2–6) days, and median hospital

stay was 16 (10–21) days. The most common pathology was solid pseudopapillary tumor

(n=11), followed by chronic pancreatitis and nesidioblastosis.

Conclusion: The high incidence of postoperative complications following pediatric pancreatic

surgery highlights the need for specialized, multidisciplinary care. Optimal outcomes can

only be achieved when these complex procedures are carried out in expert centers equipped

to manage both the surgery and its potential sequelae.