[Surgical therapy of nesidioblastosis]

Whereas today intensive-paediatric management of the acute, life-threatening situation in organically conditioned hypoglycaemias is quite successful, conservative long-term treatment of nesidioblastosis is still unsatisfactory with regard to the prevention of subsequent cerebral damage. In contrast, subtotal pancreatectomy as performed by us is a curative treatment. Chances of cure are of course greatest if the treatment is effected before the onset of secondary damage. This is demonstrated by means of the authors' own patient material which comprises 10 surgically treated children with nesidioblastosis. Three of four infants operated on during the first weeks of their lives became normoglycaemic after the operation and developed normally, whereas only two of the six remaining children operated on at a later stage in their lives showed a comparably good course of the disease. The criteria of the surgical indication, surgical mode of procedure, intraoperative and postoperative complications and results obtained by the authors, are presented.