Biermann Maya R, Sundar Preeyanka, Veeramachaneni Hima, Chawla Saurabh, Patel Vaishali, Orr Jordan, Keilin Steven, Willingham Field F
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Department of Medicine, Division of Digestive Diseases, Emory University, Atlanta, Georgia.
VideoGIE. 2023 Aug 19;9(1):45-50. doi: 10.1016/j.vgie.2023.08.007. eCollection 2024 Jan.
Insulinomas are among the most common types of functional pancreatic neuroendocrine tumors and can cause debilitating, recurrent, symptomatic hypoglycemia. Pancreatic resection can be curative, but many patients are not candidates for major pancreatic surgery. EUS-guided radiofrequency ablation (EUS-RFA) is a novel minimally invasive technique for ablation of pancreatic tumors.
In this article and accompanying video, we describe the EUS-RFA ablation device, provide instructions for device setup, and review outcomes of a case series of EUS-RFA for symptomatic insulinomas. We also review the current literature describing EUS-RFA for symptomatic pancreatic insulinomas.
This series of patients in the United States, as well as studies performed in other countries, suggests normalization of insulin levels that appears to be sustained over months to years following the procedure. There has been a favorable adverse event profile in the case series reported to date.
EUS-RFA is emerging as a promising option for the management of symptomatic insulinomas, particularly for patients who are poor surgical candidates or who decline surgery.
胰岛素瘤是最常见的功能性胰腺神经内分泌肿瘤类型之一，可导致使人虚弱的复发性症状性低血糖。胰腺切除术可治愈该病，但许多患者不适合进行大型胰腺手术。超声内镜引导下射频消融术（EUS-RFA）是一种用于消融胰腺肿瘤的新型微创技术。
在本文及随附视频中，我们描述了EUS-RFA消融设备，提供了设备设置说明，并回顾了一系列有症状胰岛素瘤的EUS-RFA病例的治疗结果。我们还回顾了目前描述有症状胰腺胰岛素瘤的EUS-RFA的文献。
美国的这一系列患者以及其他国家进行的研究表明，术后数月至数年胰岛素水平似乎持续正常化。在迄今为止报道的病例系列中，不良事件情况良好。
EUS-RFA正成为治疗有症状胰岛素瘤的一种有前景的选择，特别是对于手术条件差或拒绝手术的患者。
