The key to successful pancreatic surgery in children is a dedicated core team of experienced surgeons and staff. While most surgeons are trained to avoid the pancreas, surgeons at Children’s Hospital of Philadelphia (CHOP) have advanced training and specialized expertise needed to perform a wide variety of complex procedures on the pancreas in the smallest newborn children to young adults. 

Our team is trained in the full range of pancreatic surgeries. You can expect your child to receive a thorough consultation to carefully assess their condition and needs before any specific recommendations are made.

Why would a child need surgery on their pancreas?   

The pancreas is a gland in the upper part of the abdomen, behind the stomach and near the intestines. It is part of the digestive system and releases important hormones, such as insulin, that regulates blood sugar and aids digestion. When the pancreas is not working properly, it can cause a range of diseases including pancreatitis, pancreatic cancer, diabetes and others.  

Physicians at CHOP make every effort to medically treat children with pancreatic diseases before surgery is considered. However, some conditions may require a surgeon to remove part – or all – of the pancreas. This may be to remove a pancreatic tumor, or to improve the flow of pancreatic juices into the intestine.  

The following conditions may require a surgical approach:  

• Acute recurrent pancreatitis and chronic pancreatitis
• Congenital hyperinsulinism
• Pancreatic tumors
• Congenital pancreatic duct malformations

We discuss all treatment options with patients and their families, then select the best surgical approach for your child depending on their unique health situation and condition. The following surgical procedures are available at CHOP:  

• Total or partial pancreatectomy
• Total pancreatectomy with islet auto-transplant
• Pancreaticojejunostomy

Total or Partial Pancreatectomy

CHOP surgeons have been pioneers in operations to remove all or part of the pancreas since the 1980s. These procedures have been used to treat pediatric patients with hyperinsulinism, pancreatic tumors and focal pancreatitis. Our surgeons perform pancreatic surgery on the smallest of infants and perform the complex reconstruction needed after the pancreas is removed. CHOP is a referral center for pediatric Whipple (pancreaticoduodenectomy) procedures and the complex post-operative management that these patients require. Learn more about pancreatectomy at CHOP.   

Total Pancreatectomy with Islet Auto-Transplant (TPIAT)

For patients with acute recurrent pancreatitis or chronic pancreatitis, sometimes the only solution is to remove the diseased pancreas. To prevent diabetes, our pancreatologists (gastroenterologists with advanced training in pancreatic disorders) may recommend a total pancreatectomy with islet auto-transplant (TPIAT). The TPIAT procedure is two procedures in one:  

• First, the pancreas is removed (total pancreatectomy).
• Then, the pancreas is processed to isolate the insulin-producing islet cells. These cells are then reinfused back into your child (called islet auto-transplant) to continue natural insulin production in their body.

A successful TPIAT prevents future episodes of pancreatitis or its complications and minimizes the risk your child has of developing diabetes afterwards. CHOP’s TPIAT program started in 2014.

Pancreaticojejunostomy

For some patients with chronic pancreatitis, removing the pancreas isn’t the best treatment option. Instead, these patients may need surgery to improve the function of their pancreas – to help it work better in their body. In these cases, a lateral pancreaticojejunostomy (tailored to the specific anatomy of the child) can help a scarred or faulty pancreas function better and prevent future episodes of pancreatitis.     

Why choose CHOP for pediatric pancreatic surgery?

A global pioneer in a wide range of surgeries to improve the care of children with pancreatic disorders, the surgeons in the Pancreatic Disorders Program at Children’s Hospital of Philadelphia (CHOP) offer the most innovative and comprehensive care for children with pancreatic conditions that require surgery. Our program is one of the busiest pediatric pancreatic surgical centers in the country, offering a pancreas-focused multidisciplinary team, advanced diagnostic and surgical procedures, quick scheduling of appointments and dedicated nurse coordinators to help your family at every step. Our team of experts includes world leaders in pancreatic diseases who are constantly looking to improve care, find new treatment options and improve outcomes. We are also actively involved in clinical and translational research and have active safety and quality improvement programs.