Retrospective analysis of laparoscopic versus open treatment of annular pancreas in pediatric patient

Background: Annular pancreas is a rare congenital abnormality in the pediatric patient population. This study was to retrospectively evaluate the clinical efficacy and postoperative complications of laparoscopic or open duodenoduodenostomy for annular pancreas in pediatric patients. Methods: Total 7 pediatric patients who received laparoscopic duodenoduodenostomy and 9 cases undergoing open operation for annular pancreas were reviewed as the laparoscopic and control group, respectively. The demographic and clinical data including age, gender, body weight, premature birth and comorbidity were documented. Results: Pediatric patients in the laparoscopic and control groups were well matched with respect to the demographics and clinical data at admission (all P > 0.05). All surgeries were successfully performed and no laparoscopic procedures were converted to open surgery. The mean duration of laparoscopic surgery was 122.9 ± 22.7 min compared with 78.9 ± 10.2 min for open operation (P < 0.001). Patients in laparoscopic group had earlier removal of gastrointestinal decompression tube or Jejunal nutrient canal (3.8 ± 0.8 d vs. 6.3 ± 1.6 d, respectively, P = 0.03) than the control cases. The mean length of hospital stay after laparoscopic procedure was 12.3 ± 1.9 d, 2 days shorter than that after open operation (P = 0.011). No difference in postoperative complications was observed between the two groups (P = 0.608). Conclusions: Laparoscopic duodenoduodenostomy could be used as a safe and available treatment for annular pancreas in pediatric patients due to the earlier achievement of parenteral nutritional support and shorter hospital stay compared with the open procedure.