title: Laparoscopic spleen-preserving distal pancreatectomy as treatment for nesidioblastosis after gastric bypass surgery.
abstract: Nesidioblastosis is characterized by hyperfunction of pancreatic islets caused by hypertrophic beta cells. Postprandial symptoms of hypoglycemia are the clinical presentation of the disease. A female patient with diabetes mellitus who underwent a Roux-en-Y gastric bypass began to present postprandial symptoms of hypoglycemia. There was no radiologic (MRI) evidence of insulinoma. Selective arterial calcium-stimulation test identified hyperfunction only in the splenic artery. Laparoscopic spleen-preserving distal pancreatectomy was performed. The patient has been entirely free of any postprandial symptoms for 10 months after the partial pancreatectomy.
authors.affiliation: Department of Surgery, Federal University of Santa Maria, Rua Pinheiro Machado, 2350, 408B, Santa Maria, RS, Brasil. glaucoalvarez@terra.com.br
authors.forename: Glauco C
authors.initials: GC
authors.lastname: Alvarez
authors.forename: Everton N
authors.initials: EN
authors.lastname: Faria
authors.forename: Maristela
authors.initials: M
authors.lastname: Beck
authors.forename: Dener T
authors.initials: DT
authors.lastname: Girardon
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Machado
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D046768:Nesidioblastosis / Q000209:etiology* / Q000601:surgery*; D009765:Obesity / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*