After a median postoperative follow‐up of 6 (range 1–19) years, 13 (26%) had recurrent hypoglycemia at a mean of 7.6 ± 4.27 years after surgery, nine (69.2%) of them had a new insulinoma and four (30.8%) developed insulin‐producing liver metastases, most of these patients (9/13, 69.2%) had had the multifocal disease and had undergone multiple enucleations. The gene discussed is INS; the disease is pancreatic insulinoma.