Background

Insulinomas are usually benign, small-sized, well-encapsulated and often solitary pancreatic tumors. Currently, enucleation is the treatment of choice for sporadic solitary insulinoma if diameter is less than 2 cm and the structural integrity of the pancreatic duct can be maintained. However, the procedure has a risk of postoperative complications, and especially of pancreatic fistula. There is growing interest in endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) as an effective and less invasive alternative treatment for benign sporadic insulinoma.

Method

We retrospectively analyzed the efficacy and safety of EUS-RFA in four patients with benign localized insulinoma treated in our tertiary care center between June 2018 and November 2019. EUS-RFA was performed with a EUS-guided RFA 19-gauge needle electrode (Starmed; Taewoong Medical, Seoul, South Korea) that released energy at 50W up to 100 Ohms impedance.

Results

The series comprised three women and one man, with a median age of 58 years (range 52–82 years). Mean tumor size was 12 mm. Although three of the four patients would have been eligible for surgery, EUS-RFA was proposed to them. Symptomatic and biological improvement occurred immediately, generally straight after the procedure, in all patients, and no serious complications were observed. During the mean follow-up period of 22 months, no symptom recurrence was observed.

Conclusions

This preliminary report in 4 patients showed that EUS-RFA was an effective and relatively safe alternative treatment, devoid of major complications, for benign sporadic insulinoma. Larger-scale prospective multicenter studies are, however, needed to confirm the long-term effectiveness and safety of this novel technique.

中文翻译：

---

内镜超声引导射频消融：治疗良性胰岛素瘤的有效且安全的替代方案

背景

胰岛素瘤通常是良性的、体积小、包裹良好且通常是孤立性胰腺肿瘤。目前，对于直径小于 2 cm 且胰管结构完整性可以保持的散发性孤立性胰岛素瘤，摘除术是首选的治疗方法。然而，该手术有术后并发症的风险，尤其是胰瘘。内窥镜超声引导射频消融 (EUS-RFA) 作为一种有效且侵入性较小的良性散发性胰岛素瘤替代治疗方法越来越受到关注。

方法

我们回顾性分析了 EUS-RFA 在 2018 年 6 月至 2019 年 11 月期间在我们三级医疗中心接受治疗的四名良性局部胰岛素瘤患者的疗效和安全性。 Taewoong Medical，首尔，韩国）以 50W 释放能量，阻抗高达 100 欧姆。

结果

该系列包括三名女性和一名男性，中位年龄为 58 岁（范围 52-82 岁）。平均肿瘤大小为 12 毫米。尽管四名患者中有三名符合手术条件，但还是向他们提出了 EUS-RFA。所有患者立即出现症状和生物学改善，通常在手术后立即出现，并且没有观察到严重的并发症。在平均 22 个月的随访期内，未观察到症状复发。

结论

这份对 4 名患者的初步报告表明，EUS-RFA 是一种有效且相对安全的替代疗法，没有严重的并发症，可用于治疗良性散发性胰岛素瘤。然而，需要更大规模的前瞻性多中心研究来确认这种新技术的长期有效性和安全性。