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Retrospective analysis of 23 Chinese children with congenital hyperinsulinism undergoing pancreatectomy
Affiliations- Department of Endocrinology, Genetics and Metabolism Centre, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing, China
- Baoding Key Laboratory of Clinical Research on Children’s Respiratory and Digestive Diseases/Baoding Children’s Hospital, Baoding, Hebei, China
- Department of Surgical Oncology, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing, China
- Department of Paediatric Surgery, Children’s Hospital, Capital Institute of Paediatrics, Beijing, China
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Abstract
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.
Abstract
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.
Keywords
congenital hyperinsulinism; hypoglycaemia; pancreatectomy; 18F-DOPA PET/CT scan
About this articleTitle
Retrospective analysis of 23 Chinese children with congenital hyperinsulinism undergoing pancreatectomy
Journal
Issue
Article type
Brief communication
Pages
584-585
Published online
2021-07-12
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6342
Article views/downloads
416
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2021;72(5):584-585.
Keywords
congenital hyperinsulinism
hypoglycaemia
pancreatectomy
18F-DOPA PET/CT scan
Authors
Lin Zhang
Zi-Di Xu
Min Liu
Qiao Zeng
Rong-Min Li
Jie-Ying Wang
Huan-Min Wang
Long Li
Hong Qin
Jie Yan
Yu-Jun Wu
Cheng Zhu
Gui-Chen Ni
Yan-Mei Sang
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- Ferrara C, Patel P, Becker S, et al. Biomarkers of Insulin for the Diagnosis of Hyperinsulinemic Hypoglycemia in Infants and Children. J Pediatr. 2016; 168: 212–219.
- Lord K, De León DD. Monogenic hyperinsulinemic hypoglycemia: current insights into the pathogenesis and management. Int J Pediatr Endocrinol. 2013; 2013(1): 3.
- Galcheva S, Al-Khawaga S, Hussain K. Diagnosis and management of hyperinsulinaemic hypoglycaemia. Best Pract Res Clin Endocrinol Metab. 2018; 32(4): 551–573.
