Highlight
– Approximately 30% of infants with focal congenital hyperinsulinism (FoCHI) demonstrate early spontaneous glycemic improvement before surgery.
– Patients with less severe hypoglycemia and later diagnosis tended to achieve normoglycemia without surgical intervention.
– Surgical resection remains highly effective, but postoperative complications such as exocrine pancreatic insufficiency are primarily linked to pancreatic head resection.
– An exploratory predictive score was developed to identify candidates suitable for conservative management, potentially avoiding surgery.
