Open AccessExperience with 95% Pancreatectomy and Splenic Salvage for Neonatal Nesidioblastosis
Author(s) -
Lester W. Martin,
Frederick C. Ryckman,
Curtis A. Sheldon
Publication year - 1984
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198409000-00013
Subject(s) - medicine , nesidioblastosis , splenectomy , hypoglycemia , pancreatectomy , hyperinsulinemic hypoglycemia , sepsis , surgery , duodenum , pancreas , asplenia , spleen , insulin
Conventional 85% pancreatectomy with splenectomy performed for management of hypoglycemia of neonatal nesidioblastosis has been followed by a dismal prognosis characterized by post-splenectomy sepsis, recurrent hypoglycemia, permanent brain damage, and a high mortality. For our last eight infants we have found it possible to remove at least 95% of the pancreas, preserving the blood supply to the spleen as well as the duodenum. This has permitted satisfactory control of the hypoglycemia and long-term septic complications have been avoided. Follow-up evaluation up to 20 years with successful control of hypoglycemia without progressive brain damage indicates the value of this primary extensive surgical approach.