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Dennis A. Rasbach, MD; Jon A. van Heerden, MB, FRCS(C); Robert L. Telander, MD; Clive S. Grant, MD; J. Aidan Carney, MD

Arch Surg. 1985;120(5):584-589.

Abstract
• 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)

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.

Footnotes
Accepted for publication Feb 5, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1984.

Reprint requests to Department of Surgery, Mayo Clinic, Rochester, MN 55905 (Dr van Heerden).

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