Experience with 95% pancreatectomy and splenic salvage for neonatal nesidioblastosis.
Conventional 85% pancreatectomy with splenectomy performed for management of hypoglycemia of neonatal nesidioblastosis has been followed by a dismal prognosis characterized by post-splenectomy sepsis, recurrent hypoglycemia, permanent brain damage, and a high mortality. For our last eight infants we have found it possible to remove at least 95% of the pancreas, preserving the blood supply to the spleen as well as the duodenum. This has permitted satisfactory control of the hypoglycemia and long-term septic complications have been avoided. Follow-up evaluation up to 20 years with successful control of hypoglycemia without progressive brain damage indicates the value of this primary extensive surgical approach.
D007516:Adenoma, Islet Cell / Q000601:surgery; D002177:Candidiasis / Q000209:etiology; D006801:Humans; D007003:Hypoglycemia / Q000628:therapy; D007231:Infant, Newborn; D008586:Meningitis, Pneumococcal / Q000209:etiology; D010180:Pancreatectomy / Q000009:adverse effects; D010182:Pancreatic Diseases / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011014:Pneumonia / Q000209:etiology; D013154:Spleen / Q000502:physiology; D013156:Splenectomy / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000209:etiology