EUS-Guided Radiofrequency Ablation as a Minimally Invasive Treatment for Insulinomas-A Single-Center Experience

Area of Science:

• Gastroenterology and Endoscopy
• Oncology
• Minimally Invasive Surgery

Background:

• Insulinomas are rare functional pancreatic neuroendocrine neoplasms (pNENs) causing severe hypoglycemia.
• These tumors significantly impact patient quality of life due to recurrent episodes.
• Current treatments may involve invasive surgical procedures.

Purpose of the Study:

• To evaluate endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) as a novel, minimally invasive treatment for insulinomas.
• To assess the clinical success and safety of EUS-RFA in patients with insulinomas.

Main Methods:

• Retrospective cohort study of 17 patients with suspected insulinomas treated between 2022 and 2025.
• EUS-RFA was performed under general anesthesia for biopsy-proven pNENs (<25 mm, Ki67 <10%).
• Clinical success was defined by symptom improvement and increased blood glucose; safety was also evaluated.

Main Results:

• 100% overall clinical success rate (n=17/17) in resolving hypoglycemic symptoms.
• Normoglycemia was achieved after one EUS-RFA session in 64.7% of patients; 35.3% required a second session.
• A total of 17.4% of procedures (n=4/23) resulted in adverse events, with 8.7% being moderate.

Conclusions:

• EUS-RFA provides complete symptom resolution for insulinomas with a favorable safety profile.
• This minimally invasive technique shows promise as an alternative to conventional surgery.
• Long-term efficacy of EUS-RFA for insulinoma treatment needs further evaluation.