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Published on: July 30, 2011
Retrospective analysis of 23 Chinese children with congenital hyperinsulinism undergoing pancreatectomy
Lin Zhang1, Zi-Di Xu1, Min Liu1
1Department of Endocrinology, Genetics and Metabolism Centre, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China.
Insights
Pancreatectomy effectively treats congenital hyperinsulinism (CHI). ¹⁸F-DOPA PET/CT scanning accurately diagnoses CHI types, with partial pancreatectomy offering a high cure rate for focal CHI.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Medical Imaging
Background:
- Congenital hyperinsulinism (CHI) is a rare disorder of insulin excess.
- Pancreatectomy is a potential treatment for severe CHI.
- Accurate diagnosis and localization are crucial for effective surgical management.
Purpose of the Study:
- To evaluate the therapeutic effect and prognosis of pancreatectomy in Chinese children with CHI.
- To assess the role of ¹⁸F-DOPA PET/CT in diagnosing CHI subtypes and guiding surgical decisions.
Main Methods:
- Retrospective analysis of 23 Chinese children with CHI who underwent pancreatectomy.
- Review of clinical data, ¹⁸F-DOPA PET/CT findings, and follow-up outcomes.
- Correlation of preoperative imaging with surgical type and postoperative glycemic control.
Main Results:
- ¹⁸F-DOPA PET/CT correctly identified focal CHI in 14 patients, leading to successful partial pancreatectomy with 71% achieving normal blood glucose.
- Subtotal or near-total pancreatectomy was performed in 3 diffuse CHI cases, resulting in normal blood glucose.
- Six cases lacked preoperative scan data and underwent pancreatectomy directly due to severe hypoglycemia.
Conclusions:
- ¹⁸F-DOPA PET/CT is a reliable tool for preoperative histological typing and lesion localization in CHI.
- Partial pancreatectomy demonstrates a high cure rate for focal-type CHI.
- Surgical intervention, guided by imaging, offers significant therapeutic benefits for children with CHI.
Introduction:
The aim of the study was to discuss therapeutic effect and prognosis of pancreatectomy in the treatment of congenital hyperinsulinism (CHI).
Material And Methods:
A total of 23 Chinese children with CHI, who had undergone pancreatectomy, were selected as the study objects. The clinical data, the results of the ¹⁸Fluoro-L-3-4 dihydroxyphenylalanine positron emission tomography/computerized tomography (¹⁸F-DOPA PET/CT) scanning, and the diagnosis, treatment, and follow-up were analysed retrospectively.
Results:
Among the 23 cases, 14 patients were diagnosed with focal-type CHI via a ¹⁸F-DOPA PET/CT scan prior to the operation, with the lesions removed via partial pancreatectomy. After the operation, ten patients (71%) had normal blood glucose levels, while frequent feeding was required in four patients (29%) to control the hypoglycaemia. Three cases were diagnosed as diffuse-type CHI via preoperative scanning, two of which were treated by subtotal pancreatectomy. The other case was treated by near-total pancreatectomy, and the blood glucose level was normal following the operation. The remaining six cases were not diagnosed via the pancreatic scanning prior to the operation due to the limitation of certain conditions. Here, pancreatectomy was performed directly due to severe hypoglycaemia.
Conclusions:
¹⁸F-DOPA PET/CT scanning was a reliable method for determining the histological type and localizing the lesion before the operation. Partial pancreatectomy for focal-type CHI had a high cure rate.
