Endokrynologia Polska | 2021
Retrospective analysis of 23 Chinese children with congenital hyperinsulinemia undergoing pancreatectomy.
Abstract
OBJECTIVES\nThe clinical data of 23 cases of congenital hyperinsulinemia (CHI) treated by pancreatectomy were retrospectively analyzed, and the therapeutic effect and prognosis of pancreatectomy in the treatment of CHI were discussed.\n\n\nMETHODS\nA total of 23 Chinese children with CHI who had undergone pancreatectomy between February 2002 and March 2020 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 analyzed retrospectively.\n\n\nRESULTS\nAmong 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 hypoglycemia. Three cases were diagnosed as diffuse-type CHI via preoperative scanning, two of which were treated by subtotal pancreatectomy, with one returning to normal blood glucose levels, while a subcutaneous injection of octreotide was required in the other to prevent hypoglycemia. 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 hypoglycemia.\n\n\nCONCLUSIONS\n18F-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. In the children with diffuse-type CHI, the surgical methods were more complex and the therapeutic effect and the prognosis were also different.