Nine-year-old boy youngest in UK to undergo rare pancreas surgery

A nine-year-old boy is trying to readjust to family life after becoming the youngest person in the UK to undergo life-saving surgery, which involved removing his pancreas and injecting insulin-producing cells into his liver.

Archie Routledge, from Workington, Cumbria, has a rare genetic condition called hereditary pancreatitis. It inflames the pancreas, causing debilitating abdominal pain and significantly increasing the risk of pancreatic cancer later in life.

Archie’s mother, Emma Routledge, said he became ill when he was five. “He was rolling around in pain and screaming,” she said. There is no cure or medication to treat pancreatitis, so the family had to give him morphine at home, “which was frightening.”

After a five-month stay in the Great North Children’s Hospital in Newcastle surgeons found a “window of opportunity” to perform a procedure called “surgery.” total pancreatectomy and autologous islet cell transplantationIn this procedure, the pancreas is removed and the patient’s own insulin-producing islet cells are transplanted into the liver.

The major 15-hour operation, involving several specialists from different fields, has never been performed before in the UK on such a young person.

Archie’s parents, Emma and Mark, took time off work to stay with him in hospital, while his grandparents moved in with him to care for Archie’s sister Halle, 11.

In the hospital, Archie could not eat. He was fed through an IV.

“Being away from home and our daughter with the stress of fighting the surgery has been a really tough time for our family,” Emma said. “We are beyond relieved that we no longer have to fight pancreatitis and that Archie can live his life pain free.

“We hope that the breakthroughs in this surgery will enable other children suffering from pancreatitis to recover and continue with their lives.”

Transplant surgeon Prof Steve White was involved in the first operation of this kind when he trained in Leicester, and has performed the procedure on adults ever since, but never on someone as young as Archie. “We’re quite unique in Newcastle because we have the skills to do many different types of complex transplants,” he said.

White said removing the pancreas makes a patient diabetic, “so they have to take insulin to prevent complications such as blindness and kidney failure.”

The hope is that by reinjecting insulin-producing islet cells from the pancreas into Archie’s liver, he will be able to produce some of his own insulin.

“He still needs insulin because his pancreas is extremely damaged,” White said. “Over time, he will have better control of his diabetes because he still has some of his own cells that produce insulin.”

Archie’s genetic condition affects only one in 375,000 children and means he has a 40% higher risk of developing pancreatic cancer later in life.

His treatment was far from straightforward, as it could only be carried out once the pancreas and the resulting inflammation had stabilised. The hospital also needed funding and a national agreement for a procedure that is not routinely performed by the NHS for children.

His mother recalled the day of the surgery. “That morning we held back the tears as we gave Archie kisses and said, ‘See you soon.’ This was at 8 a.m. and we waited anxiously until we could see Archie in the intensive care unit at 11 p.m. — 15 hours later. He remained on a ventilator until the next morning, when they revived him.”

Archie is now recovering at home in Workington and is making good progress.