Long-Term Patient-Reported Outcomes After Pancreatic Surgery During Childhood, Adolescence, and Young Adulthood.
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BACKGROUND: Long-term functional and patient-reported outcomes after pancreatic surgery performed during childhood, adolescence, or young adulthood remain poorly characterized. This study assessed perioperative, long-term functional and patient-reported outcomes after pancreatic surgery in patients aged ≤21 years at the time of surgery. METHODS: Patients aged ≤21 years undergoing elective pancreatic surgery between 2000 and 2023 were retrospectively identified from a prospectively maintained database. Perioperative outcomes were assessed in all patients. Long-term pancreatic function and health-related quality of life were evaluated among surviving questionnaire respondents using the EORTC QLQ-C30 and QLQ-PAN26. Exploratory subgroup analyses used Mann-Whitney U tests with rank-biserial correlations (rrb). RESULTS: Eighty-eight patients were included. Major postoperative morbidity (Clavien-Dindo ≥III) occurred in 15 patients (17.0%), with no in-hospital or 90-day mortality. Among 83 surviving patients eligible for long-term assessment, 36 (43.4%) responded at a mean of 10.6±6.3 years after surgery. New-onset diabetes occurred in two patients (5.6%), and eleven patients (30.6%) required regular pancreatic enzyme replacement. Mean global quality-of-life score was 75.5±19.9. Compared with respondents operated on for neoplastic disease, those operated on for chronic pancreatitis reported higher physical functioning (rrb = 0.428, nominal p = 0.017) and lower pancreas-specific pain (rrb = -0.487, nominal p = 0.012). CONCLUSIONS: No perioperative mortality was observed. Among long-term respondents, patient-reported quality of life was generally favorable, while pancreatic enzyme dependence and gastrointestinal symptoms remained clinically relevant in a subset. These findings highlight the importance of long-term functional and patient-reported assessment after pancreatic surgery at a young age.