title: Single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy.
abstract: Single incision laparoscopic surgery as a surgical approach in treatment of pancreatic disease has recently been reported in adults. However, its application in persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in children is limited. In this article, we report single incision laparoscopic 90 % pancreatectomy for the treatment of persistent hyperinsulinemic hypoglycemia of infancy. Between July 2011 and February 2015, the single incision laparoscopic 90 % pancreatectomy was performed in three children with PHHI. All patients underwent (18)F-FDOPA PET/CT before the surgeries. The scans showed diffuse physiologic (18)F-FDOPA activity in entire pancreas. All patients were followed up. The levels of blood sugar and insulin were recorded postoperatively. The time required for surgery was 120-230 min, and blood loss was minimal. The hospital stay was 6 days. The duration of postoperative abdominal drainage was 4-5 days. The levels of fasting blood glucose after surgery were higher than those before surgery (4.38-8.9 vs. 0.54-1.8 mmol/L). The levels of fasting insulin after surgery were lower than those before surgery (2.4-5.5 vs. 14-33.3 uU/ml). The duration of follow-up was 4-46 months. During follow-up, the levels of blood glucose and insulin were normal in three patients. There was no recurrence of hypoglycemia after operation in all patients. Single incision laparoscopic 90 % pancreatectomy for children with PHHI is feasible and safe in well-selected cases in the experienced centers.
authors.affiliation: Department of General Surgery, Capital Institute of Pediatrics, No.2 Yabaolu Rd., Beijing, 100020, China.
authors.forename: Jin-Shan
authors.initials: JS
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Capital Institute of Pediatrics, No.2 Yabaolu Rd., Beijing, 100020, China. lilong23@126.com.
authors.forename: Long
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Surgery, Beijing United Family Hospital, Beijing, China.|Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.|Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
mesh_terms: D044903:Congenital Hyperinsulinism / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007328:Insulin / Q000097:blood; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010179:Pancreas / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography; D016896:Treatment Outcome
chemical_list: D007328:Insulin
keywords: Children; Hyperinsulinemia; Hypoglycemia; SILS