PMID- 27367988
OWN - NLM
STAT- MEDLINE
DCOM- 20170222
LR  - 20181113
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 26
DP  - 2016 Jun
TI  - Intraoperative portal vein insulin assay combined with occlusion of the pancreas 
      for complex pancreatogenous hypoglycemia: Two cases report.
PG  - e3928
LID - 10.1097/MD.0000000000003928 [doi]
LID - e3928
AB  - Intraoperative localization and confirmation of complete resection of the 
      hypersecreting tissue are the 2 main challenges in the management of 
      pancreatogenous hypoglycemia. Here, we report our experience with intraoperative 
      portal vein insulin assay combined with occlusion of the pancreas in the 
      management of pancreatogenous hypoglycemia. Clinical courses of 2 patients with 
      biochemical evidence of a pancreatogenous hypoglycemia were studied. The 
      preoperative diagnosis was multiple endocrine neoplasia 1 (MEN-1) and 
      nesidioblastosis, respectively. Rapid intraoperative portal vein insulin assay 
      combined with occlusion of the pancreas was used to localize and confirm complete 
      excision of the hypersecreting tissue. Hypoglycemia was successfully treated in 
      both the patients. In the MEN-1 patient, 2 small tumors in the head of pancreas 
      were not resected, as they were deemed noninsulin secreting by intraoperative 
      portal vein insulin assay, thus avoiding a total pancreatectomy. In the patient 
      with nesidioblastosis, using intraoperative portal vein insulin assay combined 
      with occlusion of the pancreas, an appropriate amount of pancreatic tissue was 
      resected thereby avoiding recurrence and diabetes. This technique may be of 
      particular value in patients with complex conditions such as MEN-1 and 
      nesidioblastosis, to localize and achieve complete resection of hypersecreting 
      pancreatic tissue.
FAU - Yang, Zhiying
AU  - Yang Z
AD  - Department of Hepatobiliary Surgery, China-Japan Friendship Hospital, Beijing, 
      China.
FAU - Tan, Haidong
AU  - Tan H
FAU - Sun, Yongliang
AU  - Sun Y
FAU - Si, Shuang
AU  - Si S
FAU - Xu, Li
AU  - Xu L
FAU - Liu, Xiaolei
AU  - Liu X
FAU - Liu, Liguo
AU  - Liu L
FAU - Zhou, Wenying
AU  - Zhou W
FAU - Huang, Jia
AU  - Huang J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Hypoglycemia/*blood/etiology/*surgery
MH  - Insulin/*blood
MH  - Male
MH  - *Monitoring, Intraoperative
MH  - Multiple Endocrine Neoplasia Type 1/complications/*surgery
MH  - Nesidioblastosis/complications/*surgery
MH  - Pancreatectomy/*methods
MH  - Pancreatic Ducts
MH  - Pancreatic Neoplasms/complications/*surgery
MH  - Portal Vein
PMC - PMC4937902
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/07/02 06:00
MHDA- 2017/02/23 06:00
PMCR- 2016/07/01
CRDT- 2016/07/02 06:00
PHST- 2016/07/02 06:00 [entrez]
PHST- 2016/07/02 06:00 [pubmed]
PHST- 2017/02/23 06:00 [medline]
PHST- 2016/07/01 00:00 [pmc-release]
AID - 00005792-201606280-00014 [pii]
AID - 10.1097/MD.0000000000003928 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Jun;95(26):e3928. doi: 10.1097/MD.0000000000003928.