Therapeutic Advances in Gastrointestinal Endoscopy · Published 2025-12-01 · DOI 10.1177/26317745251401315
Background: Insulinomas are the most common functional pancreatic neuroendocrine tumors (pNETs). Minimally invasive approaches like endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and ethanol ablation (EUS-EA) are emerging treatment options for small insulinomas (<2 cm). Objectives: To assess the safety, efficacy, and long-term outcomes of EUS-RFA and EUS-EA in treating small pancreatic insulinomas. Design: A retrospective, single-center study of nine patients diagnosed with insulinomas and treated with EUS ablation methods. Methods: Nine lesions (mean size 11 mm; range: 6–19 mm) were treated with EUS-RFA ( n = 7) or EUS-EA ( n = 2). EUS-RFA procedures had a mean ablation time of 31 s (range: 17–69 s), while EUS-EA used a mean ethanol volume of 1.4 ml and 0.5 ml for respective patients. All patients were followed up radiologically with CT and/or EUS for a median of 25 months (range: 6–46 months). Results: All patients had immediate hypoglycemia relief after a single treatment. The median clinical follow-up was 40 months (range: 22–60 months), with all patients remaining asymptomatic. Complete radiologic regression was observed in six patients. Two patients had minor adverse events; no severe complications occurred. Conclusion: EUS-guided ablation (RFA or EA) is a safe and effective treatment for small pancreatic insulinomas, providing symptom relief and radiologic regression. Further studies are needed to evaluate long-term efficacy and recurrence rates.
Abstract from DOAJ. Public domain (CC0 1.0).
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