Laparascopic subtotal pancreatectomy in persistent hyperinsulinemic hypoglycemia of infancy

Two and half-year old Saudi boy was diagnosed with persistent hyperinsulinemic hypoglycemia of infancy (PHHI). He was initially managed with diazoxide and octreotide, however he was medical therapy unresponsive. Surgical intervention was recommended and he had laparoscopic subtotal pancreatectomy. This is the first reported Saudi case of PHHI who was managed surgically using the laparoscopic technique and showed its safety and feasibility. We believe that laparoscopic subtotal pancreatectomy should be the initial surgical approach in PHHI children who fail the medical therapy. If the initial surgical resection was inadequate and the patient is still hypoglycemic, further pancreatic resection can be easily performed laparoscopically in the absence of adhesions and scarring.