Related Experiment Video
Updated: Jul 10, 2026
05:42
Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
The laparoscopic approach toward hyperinsulinism in children
Klaas N M A Bax1, D C van der Zee
1Sophia Children's Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands. n.bax@erasmusmc.nl
Seminars in Pediatric Surgery
|October 16, 2007
Summary
Surgery for hyperinsulinemic hypoglycemia (HH) in children is rare but necessary for therapy-resistant cases. Laparoscopic surgery, including pancreatectomy and lesion enucleation, is effective for managing HH, with a need to consider malignancy.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Genetics
Background:
- Hyperinsulinemic hypoglycemia (HH) in children requiring surgery is uncommon.
- Early HH can stem from focal or diffuse pancreatic pathology, with genetic causes identified in some cases.
- Therapy-resistant forms necessitate early surgical intervention.
Purpose of the Study:
- To review surgical management strategies for pediatric hyperinsulinemic hypoglycemia.
- To discuss diagnostic challenges and therapeutic approaches for focal and diffuse HH.
- To highlight the role of laparoscopic surgery in managing HH.
Main Methods:
- Review of surgical techniques for hyperinsulinemic hypoglycemia.
- Discussion of diagnostic modalities including 18F-DOPA PET-CT and laparoscopic exploration.
- Analysis of surgical outcomes for pancreatectomy and lesion enucleation.
Main Results:
- Preoperative differentiation between focal and diffuse HH is challenging.
- 18F-DOPA PET-CT and laparoscopic exploration show promise for diagnosis.
- Laparoscopic spleen-saving pancreatectomy and enucleation are effective surgical treatments.
- Suspicion of malignancy should always be maintained.
Conclusions:
- Laparoscopic surgery is the preferred approach for older children with HH.
- Surgical strategies vary based on whether HH is associated with MEN-1 syndrome.
- Enucleation of insulin-producing lesions and pancreatectomy are key surgical interventions for HH.
