Partial or near-total pancreatectomy for nesidioblastosis?
We report on 11 consecutive cases of nesidioblastosis successfully managed, in a 22-year period from 1972-1993 at The Children's Hospital, Birmingham, England. In the pre-operative period all patients were managed by constant glucose administration ( > 10 mg/kg/min) and hyperglycaemic agents such as diazoxide, glucagon, growth hormone and somatostatin either singly or in combination. Seven patients underwent partial pancreatectomy, 2 of whom needed a subsequent near-total resection; 4 others had a near-total pancreatectomy as the primary procedure. The 5 patients who have had partial pancreatectomies are healthy and on no regular medication. Of the 6 patients who had near-total pancreatectomy 3 require insulin for diabetes mellitus and 3 are on pancreatin for pancreatic exocrine deficiency. We recommend partial pancreatectomy as the first operation in the treatment of nesidioblastosis.
Parashar
K
K
Children's Hospital, Ladywood, Birmingham, United Kingdom.
Upadhyay
V
V
Corkery
J J
JJ
D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000628:therapy; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000235:genetics / Q000601:surgery*; D010194:Pancreatin / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome
D007328:Insulin; D010194:Pancreatin