Surgical management of medically-refractory hyperinsulinism

Retrospective study of 11 pediatric patients with medically-refractory hyperinsulinism shows focal lesions (CHI and insulinoma) are cured by localized resection, while diffuse CHI requires near-total pancreatectomy with variable outcomes. PET-CT imaging localized 66% of focal lesions; diffuse disease carries risks of diabetes and persistent hypoglycemia despite aggressive resection.