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Incidence, predictors and outcomes of redo pancreatectomy in infants with congenital hyperinsulinism: a 16-year tertiary center experience

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Abstract

Purpose

Recurrent severe hypoglycemic attacks often persist even after performing pancreatectomy for medically unresponsive congenital hyperinsulinism (CHI). In this study, we present our experience with redo pancreatectomy for CHI.

Methods

We reviewed all children who underwent pancreatectomy for CHI between January 2005 and April 2021 in our center. A comparison was made between patients whose hypoglycemia was controlled after primary pancreatectomy and patients who required reoperation.

Results

A total of 58 patients underwent pancreatectomy for CHI. Refractory hypoglycemia after pancreatectomy occurred in 10 patients (17%), who subsequently underwent redo pancreatectomy. All patients who required redo pancreatectomy had positive family history of CHI (p = 0.0031). Median extent of initial pancreatectomy was lesser in the redo group with borderline level of statistical significance (95% vs. 98%, p = 0.0561). Aggressive pancreatectomy at the initial surgery significantly (p = 0.0279) decreased the risk for the need to redo pancreatectomy; OR 0.793 (95% CI 0.645–0.975). Incidence of diabetes was significantly higher in the redo group (40% vs. 9%, p = 0.033).

Conclusion

Pancreatectomy with 98% extent of resection for diffuse CHI, especially with positive family history of CHI, is warranted to decrease the chance of reoperation for persistent severe hypoglycemia.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Qutaiba N. M. Shah Mardan, MBBS, MRCS(Eng) for proof reading and language assistance.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Pediatric Surgery, King Fahad Medical City, PO Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia

    Ali Al-Ameer

  2. Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Kingdom of Saudi Arabia

    Afrah Alsomali & Zakaria Habib

Authors
  1. Ali Al-Ameer
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  2. Afrah Alsomali
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  3. Zakaria Habib
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Ali Al-Ameer] and [Afrah Alsomali]. The first draft of the manuscript was written by [Ali Al-Ameer]. The final draft was reviewed and adjusted by [Zakaria Habib]. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ali Al-Ameer.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Ethical approval was waived by the local Research Ethics Committee of King Faisal Specialist Hospital and Research Center in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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A waiver of informed consent was granted by the institutional review board for this study.

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Cite this article

Al-Ameer, A., Alsomali, A. & Habib, Z. Incidence, predictors and outcomes of redo pancreatectomy in infants with congenital hyperinsulinism: a 16-year tertiary center experience. Pediatr Surg Int 39, 183 (2023). https://doi.org/10.1007/s00383-023-05470-6

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  • DOI: https://doi.org/10.1007/s00383-023-05470-6

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