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Postoperative complications following surgery for congenital hyperinsulinism and insulinomas in pediatric patients

Gregers Gaardskær Boel1, Henrik Thybo Christesen2,3, Mark Bremholm Ellebæk4

  • 1Medical Student, Odense University Hospital, 5000, Odense, Denmark. Gregers.gaardskaer.boel@rsyd.dk.

Pediatric Surgery International
|September 17, 2025
PubMed

Insights

Postoperative complications in pediatric surgery for hyperinsulinism (HI) were analyzed. While most patients recovered well, 8% experienced severe complications, highlighting the need for systematic evaluation.

Area of Science:

  • Pediatric Surgery
  • Endocrine Surgery
  • Surgical Complications

Background:

  • Hyperinsulinism (HI) in children, including congenital hyperinsulinism (CHI) and insulinomas, often requires complex surgical intervention.
  • Understanding postoperative complication rates is crucial for improving patient outcomes and surgical strategies.

Purpose of the Study:

  • To systematically describe and analyze postoperative complications following surgical treatment for hyperinsulinism in pediatric patients.
  • To evaluate complication rates using established grading systems like the Comprehensive Complication Index (CCI) and Clavien-Dindo Classification (CDC).

Main Methods:

  • A retrospective single-center study analyzed 89 surgeries in 74 pediatric patients with CHI or insulinomas.
  • Complications were systematically assessed using the Comprehensive Complication Index (CCI), Clavien-Dindo Classification (CDC), and Clavien-Madadi Classification (CMC).

Main Results:

  • Focal CHI surgeries had better outcomes (mean CCI 10.8) than diffuse CHI (mean CCI 26.3). Pediatric insulinoma surgery had a mean CCI of 28.9.
  • The most frequent complications were postoperative infection (29%) and delayed gastric emptying (20%).
  • Severe complications (CMD grade IIIb or higher) occurred in 8% of procedures.

Conclusions:

  • Surgery for pediatric hyperinsulinism is complex, but most patients experience an uneventful recovery.
  • Severe complications (CMD grade IIIb+) were observed in 8% of cases.
  • Prospective, systematic evaluation of postoperative complication scores is recommended for pediatric HI surgery.
Abstract

Keywords:
Congenital HyperinsulinismNear-total pancreatectomyPancreatic surgeryPediatric surgeryPostoperative complications

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