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.
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“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.
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Localization of Insulinomas to Regions of the Pancreas by Intra-arterial Stimulation with Calcium
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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
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Hormonal and Metabolic Mechanisms of Diabetes Remission after Gastrointestinal Surgery
Thaler, J. P., & Cummings, D. E. (2009) · Endocrinology · doi:10.1210/en.2009-0367 · Cited by 443
Metabolic Surgery to Treat Type 2 Diabetes: Clinical Outcomes and Mechanisms of Action
Rubino, F., Schauer, P. R., Kaplan, L. M., & Cummings, D. E. (2010) · Annual Review of Medicine · doi:10.1146/annurev.med.051308.105148 · Cited by 391
Goldfine, A. B., Mun, E. C., Devine, E., Bernier, R., Baz-Hecht, M., Jones, D. B., Schneider, B. E., Holst, J. J., & Patti, M. E. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0918 · Cited by 377
International consensus on the diagnosis and management of dumping syndrome
Scarpellini, E., Arts, J., Karamanolis, G. P., Laurenius, A., Siquini, W., Suzuki, H., Ukleja, A., van Beek, A. P., Vanuytsel, T., Bor, S., et al. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0357-5 · Cited by 316
van Beek, A. P., Emous, M., Laville, M., & Tack, J. (2017) · Obesity Reviews · doi:10.1111/obr.12467 · Cited by 288
“(116) Case report N = 2 Distal pancreatectomy (80%),”
Background
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
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