Background and Aims
Insulinomas are one of the most common functional pancreatic neuroendocrine tumors.
Surgical removal is the standard of care. Patients unfit for or refusing surgery need
an alternative nonsurgical method to alleviate symptoms. EUS has been used to localize,
aspirate, and tattoo insulinomas and to inject alcohol for local ablation. This study
is aimed at assessing the feasibility of EUS-guided radiofrequency ablation (EUS-RFA)
for managing patients with a symptomatic insulinoma by using a novel EUS-RFA needle
electrode.
Methods
The EUS-RFA system used consists of a prototype 19-gauge needle electrode, generator,
and internal cooling system. EUS-guided RFA is performed under real-time visualization
at 50 W to ablate pancreatic insulinomas.
Results
In this observational human case series from a tertiary care center, 3 patients with
a symptomatic pancreatic insulinoma, not eligible for surgery, underwent EUS-RFA by
using an internally cooled prototype needle electrode. All had rapid symptom relief
with biochemical improvement and remained symptom free at 11 to 12 months of follow-up.
There were no procedure-related adverse events.
Conclusions
EUS-RFA with the novel device can be considered in select patients with a symptomatic
pancreatic insulinoma based on preliminary findings of a beneficial effect without
adverse events. Assessment of the safety profile requires larger prospective trials.
Abbreviations:
CECT (contrast-enhanced CT), EUS-RFA (EUS–guided radiofrequency ablation), PNET (pancreatic neuroendocrine tumor), RFA (radiofrequency ablation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 19, 2015
Accepted:
August 7,
2015
Received:
March 10,
2015
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Lakhtakia at [email protected]
Identification
Copyright
© 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
