The DOI matches its Crossref record; 14 of the 15 references it cites were found in a registry or an index.
Post−Gastric Bypass Hyperinsulinism With Nesidioblastosis: Subtotal or Total Pancreatectomy May Be Needed to Prevent Recurrent Hypoglycemia
Abstract
Symptomatic hyperinsulinemic hypoglycemia and pancreatic nesidioblastosis have recently been described in a small series of patients after gastric bypass surgery for morbid obesity. In the limited published reports of patients with this condition, hyperinsulinism and nesidioblastosis have been managed with distal or subtotal pancreatectomy, with the extent of resection guided by calcium angiography. However, nesidioblastosis may involve the pancreas diffusely, and limited pancreatic resections may predispose patients to further hypoglycemic episodes. We have treated two patients with refractory hyperinsulinism and symptomatic hypoglycemia after successful gastric bypass surgery. One patient underwent an approximately 80% pancreatectomy with good results but subsequently experienced recurrent drop attacks and fainting from hyperinsulinism; a completion pancreatectomy via a pancreaticoduodenectomy was then required. A second patient had profound hyperinsulinemic hypoglycemia and was treated successfully with a subtotal (95%) pancreatectomy. Our experience, the third published report of post-gastric bypass nesidioblastosis, suggests that the risk of recurrent symptomatic hyperinsulinism after limited pancreatectomy is significant and relative euglycemia may be achieved with subtotal or total pancreatectomy.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Pancreatic resection, the most commonly reported procedure, was performed in approximately 67% of patients (66,103,105,107,114,116-123).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [116]
In the citing paper
“While some patients are relieved from all symptoms upon left-sided partial/subtotal pancreatectomy, others need to undergo total pancreatectomy for symptom control [63-65].”
Citations
Cites
Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery.
Service, G. J., Thompson, G. B., Service, F. J., Andrews, J. C., Collazo-Clavell, M. L., & Lloyd, R. V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043690 · Cited by 779
Steinbrook, R. (2004) · New England Journal of Medicine · doi:10.1056/nejmp048029 · Cited by 584
Patti, M. E., McMahon, G., Mun, E. C., Bitton, A., Holst, J. J., Goldsmith, J., Hanto, D. W., Callery, M., Arky, R., Nose, V., et al. (2005) · Diabetologia · doi:10.1007/s00125-005-1933-x · Cited by 365
Localization of Insulinomas to Regions of the Pancreas by Intra-arterial Stimulation with Calcium
Doppman, J., Chang, R., Fraker, D., Norton, J., Alexander, H., Miller, D., Collier, E., Skarulis, M., & Gorden, P. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-123-4-199508150-00004 · Cited by 279
Vilarrasa, N., Goday, A., Rubio, M. A., Caixàs, A., Pellitero, S., Ciudin, A., Calañas, A., Botella, J. I., Bretón, I., Morales, M. J., et al. (2016) · Obesity Facts · doi:10.1159/000442764 · Cited by 197
Service, F. J., Natt, N., Thompson, G. B., Grant, C. S., van Heerden, J. A., Andrews, J. C., Lorenz, E., Terzic, A., & Lloyd, R. V. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.5.5645 · Cited by 196
Anlauf, M., Wieben, D., Perren, A., Sipos, B., Komminoth, P., Raffel, A., Kruse, M. L., Fottner, C., Knoefel, W. T., Mönig, H., et al. (2005) · American Journal of Surgical Pathology · doi:10.1097/01.pas.0000151617.14598.ae · Cited by 167
Service, F. J. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.84.5.1582 · Cited by 163
Noninsulinoma pancreatogenous hypoglycemia syndrome: An update in 10 surgically treated patients
Thompson, G. B., Service, F. J., Andrews, J. C., Lloyd, R. V., Natt, N., van Heerden, J. A., & Grant, C. S. (2000) · Surgery · doi:10.1067/msy.2000.110243 · Cited by 121
Shilyansky, J., Fisher, S. J., Cutz, E., Perlman, K., & Filler, R. M. (1997) · Journal of Pediatric Surgery · doi:10.1016/s0022-3468(97)90207-4 · Cited by 105
Cited by
Sorted by citations
Items 101–133 of 133
Hyperinsulinemic Hypoglycemia After Bariatric Surgery
Yang, F., Fu, D., & Ni, Q. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2007.01772_9.x · Cited by 3
Les complications de la chirurgie bariatrique
Emungania, O. (2010) · Springer eBooks · doi:10.1007/978-2-8178-0097-4_7 · Cited by 2
Hypoglycemia after Roux-en-Y gastric bypass surgery
Molina, M., García, J., Civera, M., Ortega, J., Martínez-Valls, J. F., Martínez‐Hervás, S., Real, J. T., & Carmena, R. (2011) · Endocrinología y Nutrición (English Edition) · doi:10.1016/s2173-5093(11)70044-7 · Cited by 2
Bravo, T. A., Casado, C. F., Carrasco, A. R., Guerrero, I. M., & Marco, Á. (2012) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2011.07.008 · Cited by 2
Complications of bariatric surgery
Schulman, A. R., Ryan, M. B., & Thompson, C. C. (2015) · doi:10.1002/9781118662915.ch18 · Cited by 2
Hypoglycemia in Pancreatic Disease
Mordes, M. J. T. A. J. P. (2015) · doi:10.3998/panc.2015.11 · Cited by 2
Nesidioblastosis post-bariatric surgery in an adult patient: a case report and review of literature
Abdul-Hafez, H., Rabi, K., Sarama, A., Melhem, L., Abed, W., & Maree, M. (2025) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000003198 · Cited by 2
Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass
Ha, J., & Park, J. S. (2013) · Journal of Korean Diabetes · doi:10.4093/jkd.2013.14.2.83 · Cited by 1
Hipoglucemia tras derivación gástrica en Y de Roux
Molina, M., García, J., Civera, M., Ortega, J., Martínez-Valls, J. F., Martínez‐Hervás, S., Real, J. T., & Carmena, R. (2011) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2010.10.012 · Cited by 1
Revisional Bariatric Surgery for Management of Late Complications
Sweigert, P. J., Bakhos, F., Marcotte, E. R., & Chand, B. (2019) · Springer eBooks · doi:10.1007/978-3-030-27021-6_28 · Cited by 1
Early and Late Dumping Syndromes
Mattar, S., & Rogers, A. (2019) · The ASMBS Textbook of Bariatric Surgery · doi:10.1007/978-3-030-27021-6_23
Khalid, S., Bilal, A., Asad-Ur-Rahman, F., & Pratley, R. E. (2017) · BMJ Case Reports · doi:10.1136/bcr-2017-220600 · Cited by 1
Gut as an Endocrine Organ: The Role of Nutrient Sensing in Energy Metabolism
Wang, M. (2011) · Wiley eBooks · doi:10.1002/9780470910016.ch1 · Cited by 1
Diagnosis and Treatment of Dumping Syndrome After Gastric Bypass for Morbid Obesity
Rivero, H. G., Abdemur, A., & Rosenthal, R. J. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1710-2_16
Hipoglucemias persistentes en paciente intervenida de cirugía bariátrica
Gonzalez-Molero, I., Arnés, J. A. G., López, M., & Gallego, J. (2011) · Medicina Clínica · doi:10.1016/j.medcli.2011.01.001
Hipoglicemia por nesidioblastose: uma complicação rara da cirurgia bariátrica?
Klaus, D. G., de Carvalho, D. C., & Souza, J. C. G. (2007) · ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) · doi:10.1590/s0102-67202007000400013
Yong-xin, C., Lopez‐Hisijos, N., Chen, H., Valluru, N., & Ding, X. (2015)
Tumores neuro-endócrinos do Pâncreas
Pereira, I. B. S. D. A. (2014) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/6g7k-9x75
Dumping syndrome after bariatric surgery
Emous, M. (2019) · University of Groningen research database (University of Groningen / Centre for Information Technology) · doi:10.33612/diss.106406421
Hypoglycemia After Gastric Bypass
Alvarez, G. D. C. (2020) · Springer eBooks · doi:10.1007/978-3-030-28803-7_35
消化器がん手術(上部消化管手術)療法における栄養障害のアップデート
真司, 峯., & 比企直樹 (2011) · 静脈経腸栄養 · doi:10.11244/jjspen.26.1241
Hepprich, M., Antwi, K., Wiesner, P., Cavelti‐Weder, C., Donath, M. Y., Christ, E., & Wild, D. (2022) · Research Square · doi:10.21203/rs.3.rs-1561857/v1
Stier, C. K. (2022) · Springer eBooks · doi:10.1007/978-3-662-63705-0_13
Hyperinsulinemic Hypoglycemia After Bariatric Surgery
Yang, F., Fu, D., & Ni, Q. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2007.01771.x
Stier, C. K., Ann-Cathrin, K., & Chiappetta, S. (2020) · Springer eBooks · doi:10.1007/978-3-030-28803-7_36
Bravo, T. A., Casado, C. F., Carrasco, A. R., Guerrero, I. M., & Marco, Á. (2012) · Endocrinología y Nutrición (English Edition) · doi:10.1016/j.endoen.2011.07.013
Stier, C. K. (2023) · Springer eBooks · doi:10.1007/978-3-662-66436-0_13
Manandhar, K., Farahneh, O., Damlakhy, A., Lattouf, A., & Munoz-Monaco, G. (2024) · Cureus · doi:10.7759/cureus.59388 · Cited by 1
Metabolic and bariatric surgery: an update from 2010
Nasri, B., Lim, R. B., Ellsmere, J. C., Fernandes, A. R., & Jones, D. B. (2024) · Current Problems in Surgery · doi:10.1016/j.cpsurg.2024.101549
Pei, L., & Patti, M. (2024) · Springer eBooks · doi:10.1007/978-3-031-72309-4_34
Diagnosis and Treatment of Dumping Syndrome After Gastric Bypass for Morbid Obesity
Ganga, R., Zorrilla-Núñez, L. F., Menzo, E. L., Szomstein, S., & Rosenthal, R. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-70004-0_21
Lisboa, F. F., Junior, F., Ferreira, L., Dantas, G. D. C., & Cruz, G. (2025) · Journal of Surgery · doi:10.11648/j.js.20251303.11
Bavaria, S., Chana, A., Nurani, K., & Kimang’a, J. (2026) · World Journal of Diabetes · doi:10.4239/wjd.v17.i3.116660
Metadata
- Authors
- Clancy, T. E., Moore, F. D., & Zinner, M. J.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Clancy, Thomas E.
- Venue
- Journal of Gastrointestinal Surgery
- Publisher
- Elsevier BV
- Published
- 2006-09
- Volume
- 10
- Issue
- 8
- Pages
- 1116-1119
- ISSN
- 1091-255X (ISSN-L)
- OpenAlex
- W2099409010
- Cited by
- 133
- References
- 15
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 10 · 2015: 9 · 2014: 10 · 2013: 6 · 2012: 9
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gastrointestinal Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
- Keywords
- recurrent hypoglycemia, subtotal pancreatectomy, total pancreatectomy, pancreaticoduodenectomy, morbid obesity, bariatric surgery complications, hyperinsulinemic-euglycemic clamp
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Hyperinsulinism, Hypoglycemia, Middle Aged, Obesity, Morbid, Pancreatectomy, Postoperative Complications, Prognosis, Gastric Bypass, Nesidioblastosis, Secondary Prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
