Journal article
The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee
Journal of pediatric gastroenterology and nutrition, Vol.74(5), pp.706-719
05/01/2022
DOI: 10.1097/MPG.0000000000003439
PMCID: PMC10286947
PMID: 35258494
Abstract
Chronic pancreatitis (CP) is rare in childhood but impactful because of its high disease burden. There is limited literature regarding the management of CP in children, specifically about the various surgical approaches. Herein, we summarize the current pediatric and adult literature and provide recommendations for the surgical management of CP in children.
The literature review was performed to include the scope of the problem, indications for operation, conventional surgical options as well as total pancreatectomy with islet autotransplantation, and outcomes following operations for CP.
Surgery is indicated for children with debilitating CP who have failed maximal medical and endoscopic interventions. Surgical management must be tailored to the patient's unique needs, considering the anatomy and morphology of their disease. A conventional surgical approach (eg, drainage operation, partial resection, combination drainage-resection) may be considered in the presence of significant and uniform pancreatic duct dilation or an inflammatory head mass. Total pancreatectomy with islet autotransplantation is the best surgical option in patients with small duct disease. The presence of genetic risk factors often portends a suboptimal outcome following a conventional operation.
The morphology of disease and the presence of genetic risk factors must be considered while determining the optimal surgical approach for children with CP. Surgical outcomes for CP are variable and depend on the type of intervention. A multidisciplinary team approach is needed to assure that the best possible operation is selected for each patient, their recovery is optimized, and their immediate and long-term postoperative needs are well-met.
Details
- Title: Subtitle
- The Role of Surgical Management in Chronic Pancreatitis in Children: A Position Paper From the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee
- Creators
- Jaimie D Nathan - Nationwide Children's HospitalKate Ellery - University of Pittsburgh Medical CenterKeshawadhana Balakrishnan - Texas Children's HospitalHeli Bhatt - University of Minnesota, Masonic Children's Hospital, Minneapolis, Minnesota, United States.Armando Ganoza - University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Hillman Center for Pediatric Transplantation, Pittsburgh, Pennsylvania, United States.Sohail Z Husain - Lucile Packard Children's HospitalRakesh Kumar - ProMedica Russell J. Ebeid Children's HospitalVeronique D Morinville - Montreal Children's HospitalJ Antonio Quiros - Icahn School of Medicine at Mount SinaiSarah J Schwarzenberg - University of MinnesotaZachary M Sellers - Lucile Packard Children's HospitalAliye Uc - University of IowaMaisam Abu-El-Haija - Cincinnati Children's Hospital Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric gastroenterology and nutrition, Vol.74(5), pp.706-719
- DOI
- 10.1097/MPG.0000000000003439
- PMID
- 35258494
- PMCID
- PMC10286947
- ISSN
- 0277-2116
- eISSN
- 1536-4801
- Language
- English
- Date published
- 05/01/2022
- Academic Unit
- Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984313082402771
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