title: [Pancreatic hyperinsulinism--changes of the clinical picture and importance of differences in sporadic disease course (experience with 144 patients operated in the period 1986-2009)].
abstract: The diagnoses of pancreatogenic hyperinsulinism and insulinoma (benign or malignant) were almost synonomously used during the last decades. Only familial forms of hyperinsulinism, i. e., in patients with multiple endocrine neoplasia type 1 were separately discussed. The surgical literature concentrated on technical questions, comparing open and minimal invasive techniques. The clinical diagnosis of patients with pancreatogenic hypo-glycaemia syndrome (NIPHS) and the pathological diagnosis of insulinomatosis has now opened up new questions in the diagnosis and therapy of pancreatogenic hyperinsulinism. On the basis of our experience from 144 patients operated on for pancreatogenic hyperinsulinism during the last 22 years with 16 NIPHS patients and with the help of the relevant literature, we explain the prerequisites that surgical therapy has to fulfil in the treatment of patients with pancreatogenic hyperinsulinism today.
authors.affiliation: Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Chirurgische Klinik I, Neuss, Deutschland. pgoretzki@lukasneuss.de
authors.forename: P
authors.initials: P
authors.lastname: Goretzki
authors.forename: A
authors.initials: A
authors.lastname: Starke
authors.forename: B
authors.initials: B
authors.lastname: Lammers
authors.forename: K
authors.initials: K
authors.lastname: Schwarz
authors.forename: H-D
authors.initials: HD
authors.lastname: Röher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium; D003299:Cooperative Behavior; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis* / Q000601:surgery*; D007003:Hypoglycemia / Q000175:diagnosis / Q000601:surgery; D007340:Insulinoma / Q000175:diagnosis* / Q000601:surgery*; D033183:Interdisciplinary Communication; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis* / Q000601:surgery*; D046768:Nesidioblastosis / Q000175:diagnosis* / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D002118:Calcium