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May 1985

Surgical Management of Hyperinsulinism in the Multiple Endocrine Neoplasia, Type 1 Syndrome

Author Affiliations

From the Departments of Surgery (Drs Rasbach, van Heerden, Telander, and Grant) and Pathology (Dr Carney), Mayo Clinic and Mayo Foundation, Rochester, Minn. Dr Rasbach is a visiting clinician from the Milton S. Hershey Medical Center, Hershey, Pa.

Arch Surg. 1985;120(5):584-589. doi:10.1001/archsurg.1985.01390290062010

• We retrospectively reviewed the records of 12 patients from one institution (from 1970 through 1983) who had hyperinsulinism as a part of the multiple endocrine neoplasia, type 1 syndrome. All of the patients underwent surgical exploration: ten had subtotal pancreatectomies, one had enucleation, and one underwent a total pancreatectomy. There was no operative mortality. Preoperative and intraoperative localization studies (angiography and ultrasonography) tended to underestimate the number of pancreatic tumors. Ten patients had multiple B-cell adenomas (mean, 7.4), while two patients had single tumors. This study confirms that hyperinsulinism, when it occurs as part of the multiple endocrine neoplasia, type 1 syndrome, is usually due to multiple islet cell tumors, and that the islet cell tissue is probably diffusely dysplastic. Subtotal (85%) pancreatectomy is suggested as the procedure of choice for this subgroup of patients with hyperinsulinism.

(Arch Surg 1985;120:584-589)

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