Context: Nesidioblastosis is a rare cause of non insulinoma pancreatogenous hypoglycemic syndrome seen in adults. It is characterized by postprandial hypoglycemia with high insulin and C-peptide levels without any detectable pancreatic lesion. The definitive diagnosis can be made only on histopathological examination of the resected specimen.
Case Report: We report a case of a 50-year-old lady presenting with hypoglycemic attacks being misdiagnosed preoperatively as insulinoma and treated with enucleation leading to recurrence of symptoms after 6 months. Later medical therapy was tried which failed and patient needed subtotal pancreatectomy for resolution of symptoms.
Conclusion: Nesidioblastosis should be suspected in patients with endogenous hyperinsulinemic hypoglycemia without any detectable pancreatic tumor on preoperative imaging.
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http://dx.doi.org/10.6092/1590-8577/1352 | DOI Listing |
World J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China.
Background: Pancreatic cancer involving the pancreas neck and body often invades the retroperitoneal vessels, making its radical resection challenging. Multimodal treatment strategies, including neoadjuvant therapy, surgery, and postoperative adjuvant therapy, are contributing to a paradigm shift in the treatment of pancreatic cancer. This strategy is also promising in the treatment of pancreatic neck-body cancer.
View Article and Find Full Text PDFArq Bras Cir Dig
January 2025
Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery, Digestive Diseases Surgical Unit - Campinas (SP), Brazil.
Background: Gastric stump neoplasia is defined as a neoplasia that arises in the gastric remnant after at least 5 years of interval from the first gastric resection.
Aims: The aim of this study was to analyze 51 patients who underwent total and subtotal gastrectomy and multi-visceral resections in patients with gastric stump cancer.
Methods: The hospital records of 51 patients surgically treated for gastric stump cancer between 1989 and 2019 were reviewed.
Ann Surg Oncol
January 2025
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Ann Surg Oncol
December 2024
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Background: For premalignant main duct intraductal papillary mucinous neoplasms (MD-IPMN), laparoscopic duodenum and spleen-preserving subtotal or total pancreatectomy (LDSP-STP/TP) seems to be a viable option for parenchyma-sparing pancreatectomy.
Patients And Methods: On the basis of the imaging features, family history, genomic alterations, intraoperative ultrasound examination, and frozen section evaluation, we have proposed patient selection strategies for the LDSP-STP/TP technique for the first time. Additionally, a comprehensive step-by-step overview of this technique has been provided.
Surg Endosc
November 2024
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
Background: Intraoperative conversion to open surgery is an adverse event during minimally invasive distal pancreatectomy (MIDP), associated with poor postoperative outcomes. The aim of this study was to develop a model capable of predicting conversion in patients undergoing MIDP.
Methods: A total of 352 patients who underwent MIPD were included in this retrospective analysis and randomly assigned to training and validation cohorts.
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