PDF herunterladen
Eur J Pediatr Surg 2017; 27(04): 368-372
DOI: 10.1055/s-0037-1603524
Special Report
Georg Thieme Verlag KG Stuttgart · New York

Cavitron Ultrasonic Surgical Aspirator-Assisted Pancreatic Resection in Hyperinsulinism

Logan Bond
1   Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Zaria Murrell
1   Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Tiffany Wright
1   Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Sheldon Bond
1   Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

07. April 2017

11. April 2017

Publikationsdatum:
23. Mai 2017 (online)

    Lizenzen und Reprints

Abstract

Introduction Diffuse congenital hyperinsulinemia continues to be poorly responsive to medical management. Surgical resection for this entity can be variable in extent and efficacy.

Materials and Methods This report describes a unique method of pancreatic resection for diffuse familial congenital hyperinsulinemia. The procedure maximizes pancreatic parenchymal removal while preserving blood supply to the vital structures adjacent to the head of the pancreas. Two cases of familial congenital hyperinsulinism are presented as well as a review of the current surgical literature.

Results The Cavitron ultrasonic surgical aspirator has been used successfully to assist in maximum resection of pancreatic tissue while preserving blood supply to the duodenum and common bile duct.

Conclusion This report describes a useful technique of maximizing pancreatic resection for patients with diffuse congenital hyperinsulinemia which preserves adjacent vital structures.

Keywords

hyperinsulinism - children - surgical
 

  • References

  • 1 Roženková K, Güemes M, Shah P, Hussain K. The diagnosis and management of hyperinsulinaemic hypoglycaemia. J Clin Res Pediatr Endocrinol 2015; 7 (02) 86-97
    CrossrefPubMedGoogle Scholar
  • 2 Fékété CN, de Lonlay P, Jaubert F, Rahier J, Brunelle F, Saudubray JM. The surgical management of congenital hyperinsulinemic hypoglycemia in infancy. J Pediatr Surg 2004; 39 (03) 267-269
    CrossrefPubMedGoogle Scholar
  • 3 Adzick NS, Thornton PS, Stanley CA, Kaye RD, Ruchelli E. A multidisciplinary approach to the focal form of congenital hyperinsulinism leads to successful treatment by partial pancreatectomy. J Pediatr Surg 2004; 39 (03) 270-275
    CrossrefPubMedGoogle Scholar
  • 4 De León DD, Stanley CA. Mechanisms of disease: advances in diagnosis and treatment of hyperinsulinism in neonates. Nat Clin Pract Endocrinol Metab 2007; 3 (01) 57-68
    CrossrefPubMedGoogle Scholar
  • 5 Stanley CA. Perspective on the genetics and diagnosis of congenital hyperinsulinism disorders. J Clin Endocrinol Metab 2016; 101 (03) 815-826
    CrossrefPubMedGoogle Scholar
  • 6 de Lonlay-Debeney P, Poggi-Travert F, Fournet JC. , et al. Clinical features of 52 neonates with hyperinsulinism. N Engl J Med 1999; 340 (15) 1169-1175
    CrossrefPubMedGoogle Scholar
  • 7 Pierro A, Nah SA. Surgical management of congenital hyperinsulinism of infancy. Semin Pediatr Surg 2011; 20 (01) 50-53
    CrossrefPubMedGoogle Scholar
  • 8 Lovvorn III HN, Nance ML, Ferry Jr RJ. , et al. Congenital hyperinsulinism and the surgeon: lessons learned over 35 years. J Pediatr Surg 1999; 34 (05) 786-792 , discussion 792–793
    CrossrefPubMedGoogle Scholar
  • 9 Park HH, Kim HY, Jung SE, Lee SC, Park KW. Long-term functional outcomes of PPPD in children--nutritional status, pancreatic function, GI function and QOL. J Pediatr Surg 2016; 51 (03) 398-402
    CrossrefPubMedGoogle Scholar
  • 10 d'Ambrosio G, del Prete L, Grimaldi C. , et al. Pancreaticoduodenectomy for malignancies in children. J Pediatr Surg 2014; 49 (04) 534-538
    CrossrefPubMedGoogle Scholar
  • 11 Mansfield SA, Mahida JB, Dillhoff M. , et al. Pancreaticoduodenectomy outcomes in the pediatric, adolescent, and young adult population. J Surg Res 2016; 204 (01) 232-236
    CrossrefPubMedGoogle Scholar
  • 12 Choi JS. Cavitron Ultrasonic Surgical Aspirator. In: Feldman L, Fuchshuber P, Jones DB. , eds. The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE). New York: Springer; 2012: 133-138
    CrossrefGoogle Scholar
  • 13 Snajdauf J, Rygl M, Petru O. , et al. Duodenum-sparing technique of head resection in solid pseudopapillary tumor of the pancreas in children. Eur J Pediatr Surg 2009; 19 (06) 354-357
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 14 Snajdauf J, Pýcha K, Rygl M. , et al. Papillary cystic and solid tumor of the pancreas--surgical therapy with the use of CUSA, and a review of the pediatric literature. Eur J Pediatr Surg 1999; 9 (06) 416-419
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Ernst S, Demirci C, Valle S, Velazquez-Garcia S, Garcia-Ocaña A. Mechanisms in the adaptation of maternal β-cells during pregnancy. Diabetes Manag (Lond) 2011; 1 (02) 239-248
    PubMedGoogle Scholar
  • 16 Dhawan S, Georgia S, Bhushan A. Formation and regeneration of the endocrine pancreas. Curr Opin Cell Biol 2007; 19 (06) 634-645
    CrossrefPubMedGoogle Scholar
  • 17 Berrocal T, Luque AA, Pinilla I, Lassaletta L. Pancreatic regeneration after near-total pancreatectomy in children with nesidioblastosis. Pediatr Radiol 2005; 35 (11) 1066-1070
    CrossrefPubMedGoogle Scholar
  • 18 Beltrand J, Caquard M, Arnoux JB. , et al. Glucose metabolism in 105 children and adolescents after pancreatectomy for congenital hyperinsulinism. Diabetes Care 2012; 35 (02) 198-203
    CrossrefPubMedGoogle Scholar