[Clinical management of persistent primary hyperparathyroidism].

Persistent hypercalcemia following operation for hyperparathyroidism presents a challenge to both the patient and the surgeon. Between 1/79 and 3/90 a total of 351 patients with parathyroid disease were operated and 34 (10%) patients had persistent hyperparathyroidism. Average age was 62 years. 1/3 of pat. was asymptomatic and 1/3 had renal calculi. Preoperative studies were successful in diagnosing the affected side in 34% using CT, in 44% using sonography and in 63% when selective venous catheterization was used. A total of 44 operations were performed in 34 pat. Up to three operations were performed in 24% of patients. Eight of 34 pat. have refused additional surgery. Repeated surgery was successful in 24 pat. In eight pat. ectopic glands were identified and six of these were located in the mediastinum.