Surgical Management of Hyperinsulinism in the Multiple Endocrine Neoplasia, Type 1 Syndrome

Dennis A. Rasbach, MD; Jon A. van Heerden, MB, FRCS(C); Robert L. Telander, MD; Clive S. Grant, MD; J. Aidan Carney, MD
Arch Surg. 1985;120(5):584-589. doi:10.1001/archsurg.1985.01390290062010.
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• We retrospectively reviewed the records of 12 patients from one institution (from 1970 through 1983) who had hyperinsulinism as a part of the multiple endocrine neoplasia, type 1 syndrome. All of the patients underwent surgical exploration: ten had subtotal pancreatectomies, one had enucleation, and one underwent a total pancreatectomy. There was no operative mortality. Preoperative and intraoperative localization studies (angiography and ultrasonography) tended to underestimate the number of pancreatic tumors. Ten patients had multiple B-cell adenomas (mean, 7.4), while two patients had single tumors. This study confirms that hyperinsulinism, when it occurs as part of the multiple endocrine neoplasia, type 1 syndrome, is usually due to multiple islet cell tumors, and that the islet cell tissue is probably diffusely dysplastic. Subtotal (85%) pancreatectomy is suggested as the procedure of choice for this subgroup of patients with hyperinsulinism.

(Arch Surg 1985;120:584-589)


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