What is the role of pancreatic surgery in the treatment of pediatric hypoglycemia?

Updated: Feb 19, 2018
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Surgery for hyperinsulinism is usually performed when medical therapy fails or when the patient is an older child with a possible insulin-producing tumor. If focal disease has been identified in an area of the pancreas that is amenable to removal without damage to the rest of the organ, surgery can be performed.

In diffuse disease, the usual initial operation in infants with persistent hyperinsulinemic hypoglycemia of infancy is to remove 95% of the pancreas. If this is unsuccessful, drug therapy may be added or a complete pancreatectomy may be performed. In the child with an insulin-producing tumor, only the tumor is removed. The surgeon locates the tumors intraoperatively using palpation or intraoperative ultrasonography.


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