Subtotal laparoscopic pancreatectomy for the treatment of hyperinsulinism in a 12-year-old girl
Epublication WebSurg.com, Mar 2012;12(03). URL: http://websurg.com/doi/vd01en3602
We present the case of a 12-year-old girl who presented with symptoms of dizziness and weakness for 4 months. Hyperinsulinemic hypoglycemia was found. Pancreatic PET-scan and CT-scan showed no focal lesions and a slightly increased volume of the pancreatic tail. After selective calcium stimulation of the pancreas, increased insulin was found from the body and tail. Laparoscopic pancreatectomy was scheduled. Failure with prednisone treatment indicated laparoscopic subtotal pancreatectomy. Surgery was carried out using a four-trocar technique. The pancreas was approached through the greater omentum. Careful dissection of the small pancreatic vessels coming from the splenic vessels is performed. A subtotal pancreatectomy near the duodenum was carried out by means of the Endo-GIA® linear stapler in the head and ultrasonic scalpel and hook in the body and tail. Drainage was left in situ.