Whipple's surgery for childhood periampullary neoplasms: a report of 4 cases and literature review

Objective To explore the experience of Whipple's surgery in the treatment of periampullary neoplasms in children. Methods Clinical data were retrospectively analyzed for 4 children undergoing Whipple's surgery from January 2016 to December 2017. Systematic analysis and reviews of pediatric Whipple's surgery were performed for the Chinese and English literature retrieved from the databases of Pubmed, Medline, Springer Link, CNKI and Wanfang. Results There were 2 boys and 2 girls with an average age of 7(4-12) years. The average operative duration was 402 (345-455) min, the intraoperative blood loss 100-700 ml and the mean bleeding volume was 262.5 ml; The neoplastic histology were solid pancreatic pseudopapillary tumor, pancreatoblastoma, bile duct grapevine embryonal rhabdomyosarcoma and B-cell lymphoblastoma respectively. All cases had excellent outcomes without complications during follow-ups. Forty-nine children with complete data were reported in 14 English articles and 2 Chinese articles were retrieved. Conclusions Whipple's surgery plus chemotherapy are efficacious for periampullary neoplasms in children. Surgical indications should be strictly mastered. Intraoperative exploration and freeze biopsy are helpful for selecting surgical approaches. Key words: Pancreatoduodenectomy; Tumor; Complication