title: Nesidioblastosis treated successfully by 85% pancreatectomy.
abstract: Nesidioblastosis is a rare disorder in pediatric surgery. It is caused by hypertrophy and hyperplasia of the islands of Langerhans, and can lead to persistent hyperinsulinemic hypoglycemia. If appropriate treatment is delayed there is a high risk of the development of cerebral palsy, impaired mental development, epilepsy or other forms of irreversible brain damage, so early detection and early treatment to stabilize serum glucose levels is essential. Initial treatment consists of nutritional management with administration of an adequate amount of calories along with drug therapy using diazoxide. In cases that are resistant to drug therapy a subtotal pancreatectomy is performed. Conventional recommended practice has been to perform a 95% pancreatectomy, however this can lead to the onset of diabetes due to abnormal pancreatic endocrine function. We report here a case of nesidioblastosis in which we performed an 85% pancreatectomy. Postoperative clinical course has been excellent, with no recurrence or impaired glucose tolerance during the four years since the operation.
authors.affiliation: Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. yoshi456@med.kurume-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakawa
authors.forename: Kimio
authors.initials: K
authors.lastname: Asagiri
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Akiyoshi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hikida
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mizote
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D006801:Humans; D007223:Infant; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery*; D010289:Parenteral Nutrition, Total
chemical_list: D001786:Blood Glucose