Solid pseudopapillary tumor of the pancreas in children: Need of a nutritional follow up algorithm

Aim of the study: Gold standard in the treatment of solid pseudopapillary tumor of the pancreas (SPTP) remains pancreatic resection. The aim of the study is to determine an algorithm for the nutritional follow up of these patients. Methods: This monocentric retrospective study includes all pediatric patients with pancreas resection for SPTP from August 2004 to December 2012. The following criteria were studied: nutritional follow up (using weight for height index) in the pre- and post-operative period ( 1 month, u003e 6 months); fecal elastase, pancreatic enzyme substitution and stool consistency. Results: Five female patients, mean age 13.4 years with SPTP underwent pancreatic resection. A close nutritional follow up based on the weight for height index (WHI) demonstrated that 2 out of 5 patients recover to a normal nutritional state at 6 months post-surgery, whereas the other three maintained their normal nutritional state. Eighty percent of patients needed pancreatic enzyme substitution for more than 6 months and all of them had a decreased fecal elastase (i.e u003c200mcg/g). Conclusion: SPTP is a rare tumor with a low malignant potential. Nevertheless in complement to surgical resection, a close nutritional follow up is mandatory for the patient’s well-being and quality of life. Based on simple and cost effective parameters (weight, height and fecal elastase) and a review of the literature, we propose a clinically applicable algorithm for their nutritional follow-up.