EUS-guided alcohol ablation of an insulinoma

Jürgensen, Christian; Schuppan, Detlef; Neser, Frank; Ernstberger, Jan; Junghans, Ulrich; Stölzel, Ulrich

doi:10.1016/j.gie.2005.10.034

Cited by 186 publications

(139 citation statements)

References 9 publications

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“…In non-functioning tumours the issue of follow-up is more complex. Some authors performed follow-up EUS (also in insulinoma) and it revealed partial or total tumour size regression [17,19,28]. However, we are not able to predict long-term results and the risk of development of metastases and recurrence of the disease [22,28,31,32].…”

Section: Opis Przypadkumentioning

confidence: 74%

“…EUS-guided ethanol ablation of pancreatic insulinoma is a novel method, first reported by the group of Jürgensen C. et al [17]. The Medline database research shows 14 cases or case series of insulinoma EUS-guided ethanol ablation [17][18][19][20][21][22][23][24][25][26][27].…”

Section: Opis Przypadkumentioning

confidence: 99%

“…The Medline database research shows 14 cases or case series of insulinoma EUS-guided ethanol ablation [17][18][19][20][21][22][23][24][25][26][27]. Moreover, there are also reports of alcoholic ablation of other pancreatic tumours of neuroendocrine and other origin (especially cystic pancreatic tumours) [28][29][30].…”

Section: Opis Przypadkumentioning

confidence: 99%

“…The side effects were generally mild and self-limiting: mild acute pancreatitis, fever, abdominal pain [17,18,22,28]. Only one described event should be classified as severe-bleeding from duodenal ulcer (Forrest 2a) with haematoma, which was treated conservatively with proton pump inhibitor [19].…”

Section: Opis Przypadkumentioning

confidence: 99%

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Successful EUS-guided ethanol ablation of insulinoma, four-year follow-up. Case report and literature review

Dąbkowski

Gajewska

et al. 2017

Endokrynologia Polska

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Introduction: EUS-guided ethanol ablation of insulinoma is a new method of treatment of this neuroendocrine tumour. Ablation is recommended in patients who are poor surgical candidates or refuse surgery. We present a case of an 81-year-old female with symptomatic insulinoma, treated successfully with EUS-guided alcoholic ablation, along with a literature review including 28 other previously described cases. The effectiveness, safety of the therapy, and technical procedure-related issues are summarised. To the best of our knowledge, this is the first described case of successful insulinoma EUS-guided ablation in Poland. Material and methods:We searched the PubMed/Medline database to identify cases of EUS-guided alcoholic ablation. Our analysis included 14 articles (case reports or case series), with a total of 27 patients and 31 tumours described, published before February 2017. Results: The described tumours were relatively small (mean 13 mm), and the most common location was pancreatic head. The mean ethanol volume injected to the tumour was 1.8 ml and the concentration of infused alcohol varied from 95% to 98%.Side effects were observed in six cases; apart from one, they were mild and self-limiting. There was only one severe adverse event, treated conservatively with success. The median follow-up was 14.4 months (2-55 months). In all described cases ablation led to improvement of the symptoms and normalisation of glycaemia. Conclusions:The EUS-guided alcoholic ablation of insulinoma is a safe and effective method of treatment in patients who are poor surgical candidates and/or refuse surgery. The adverse effects are rare and mild and were observed when the volume of injected ethanol was equal to or above 3.0 ml. However, the data is limited, the follow-up is relatively short, and prospective studies are needed to confirm the long-term effects of treatment. The study shows also that there are important procedural differences (concentration and volume of alcohol, needle gauge, number of sessions) between the endoscopists, which should be specified. (Endokrynol Pol 2017; 68 (4): 472-479)

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Section: Opis Przypadkumentioning

confidence: 74%

Section: Opis Przypadkumentioning

confidence: 99%

Section: Opis Przypadkumentioning

confidence: 99%

Section: Opis Przypadkumentioning

confidence: 99%

See 2 more Smart Citations

Successful EUS-guided ethanol ablation of insulinoma, four-year follow-up. Case report and literature review

Dąbkowski

Gajewska

et al. 2017

Endokrynologia Polska

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“…guidance and can detect and drain ascites not apparent on CT. 25,26 Experimental applications of EUS undergoing current study include local delivery of brachytherapy or chemotherapy in advanced pancreatic cancer, 27 alcohol ablation of adrenal metastases 28 or pancreatic neuroendocrine tumours 29 and EUS-guided submucosal implantation of radiopaque markers prior to radiotherapy. 30 The rapid development of natural orifice transluminal endoscopic surgery is now blurring the boundaries between endoscopy and surgery with EUS playing a key role in its future.…”

Section: Therapeutic Endoscopic Ultrasoundmentioning

confidence: 99%

Endoscopic ultrasound: what is it and when should it be used?

Reddy

Willert

2009

Clinical Medicine

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-Endoscopic ultrasound (EUS) is an increasingly available diagnostic and therapeutic tool used within the UK. It has wide applications both in the gastrointestinal tract and mediastinum with its current main uses being in the staging of luminal malignancies and assessment of pancreatic and subepithelial lesions. The emergence of linear EUS has opened up new therapeutic avenues with fine needle aspiration, trucut biopsies, coeliac plexus blocks and transmural pseudocyst drainage all now possible. Future developments include localised brachytherapy/chemotherapy and alcohol ablation of unresectable pancreatic malignancies and EUSguided endoscopic surgery.

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Therapeutic EUS for cancer treatment

Ghassemi

Muthusamy

2016

Endoscopic Ultrasonography

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EUS-guided alcohol ablation of an insulinoma

Cited by 186 publications

References 9 publications

Successful EUS-guided ethanol ablation of insulinoma, four-year follow-up. Case report and literature review

Successful EUS-guided ethanol ablation of insulinoma, four-year follow-up. Case report and literature review

Endoscopic ultrasound: what is it and when should it be used?

Therapeutic EUS for cancer treatment

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