Laparoscopic Surgery for Focal-form Congenital Hyperinsulinism Located in Pancreatic Head

Two infants with persistent hypoglycemia and elevated insulin levels were diagnosed with CHI and underwent laparoscopic near-total pancreatic head resection due to a suboptimal response to medical therapy and the likelihood of focal disease amenable to surgery.  

The operative duration was 300-330 min, and the intraoperative blood loss was minimal. The duration of postoperative abdominal drainage was 4-5 days. Neither intra- nor postoperative abdominal complications occurred. Oral feeding was resumed 3-4 days after the operation, and the blood glucose level gradually stabilized to within the normal range. Normal blood glucose was observed in both patients over a follow-up period of 3-6 months. 

To the best of our knowledge, this is the first report of successful laparoscopic near-total pancreatic head resection for focal pancreatic head CHI. In summary, we have demonstrated that laparoscopic pancreatic head resection with Roux-en-Y pancreaticojejunostomy is a safe and effective procedure in neonates and small infants with CHI.