Endoscopic ultrasound radiofrequency ablation of pancreatic insulinoma in elderly patients:Three case reports  

作　　者：Gemma Rossi Maria Chiara Petrone Gabriele Capurso Stefano Partelli Massimo Falconi Paolo Giorgio Arcidiacono 

机构地区：[1]Division of Pancreato-Biliary Endoscopy and Endosonography,Pancreas Translational and Clinical Research Center,San Raffaele Scientific Institute IRCCS,Vita-Salute San Raffaele University,Milano 20132,Italy [2]Department of Pancreatic Surgery,Pancreas Translational and Clinical Research Center,San Raffaele Scientific Institute IRCCS,Vita-Salute San Raffaele University,Milano 20132,Italy

出　　处：《World Journal of Clinical Cases》2022年第19期6514-6519,共6页世界临床病例杂志

摘　　要：BACKGROUND Endoscopic ultrasound(EUS)-guided radiofrequency ablation(RFA)has recently been proposed as a local treatment for functional pancreatic neuroendocrine neoplasms in patients unfit for surgery,in order to obtain clinical syndrome regression.Data on the safety and long-term effectiveness of this approach are scarce,and EUS-RFA procedures are not standardized.CASE SUMMARY The present case series reports 3 elderly patients with a pancreatic insulinoma and comorbidities,locally treated by EUS-guided RFA with clinical success in terms of hypoglycemic symptoms.RFA procedures were performed during deep sedation,under EUS control with a 19 G needle,an electrode 5-mm in size at a power of 30 W and multiple RFA applications during the same session in order to treat the whole area of the lesions.Immediate relief of symptoms was evident in 2 patients after the first EUS-RFA,while in the third patient a second endoscopic treatment was needed.All 3 patients are symptom-free without need of medications after 24 mo of follow-up with imaging follow-up showing no disease recurrence.A single adverse event of intraprocedural bleeding occurred,which was successfully treated endoscopically.CONCLUSION EUS-RFA represents an effective and safe alternative to surgery for the treatment of insulinomas in elderly patients at high surgical risk.However,larger multicenter studies withlonger follow-up are needed in order to better assess its safety and clinical success.

关 键 词：Endoscopic ultrasound Radiofrequency ablation INSULINOMAS Neuroendocrine neoplasms Ablative therapies Case report 

分 类 号：R735.9[医药卫生—肿瘤]