Endoscopy 2024; 56(S 02): S480-S481
DOI: 10.1055/s-0044-1783921
Abstracts | ESGE Days 2024
ePoster

Endoscopic Ultrasound-Guided Radiofrequency (EUS-RFA) and Ethanol Ablation (EUS-EA) of Pancreatic Neuroendocrine Tumors and Adenocarcinoma: A Prospective Multicenter Study

Authors

  • H. H. Okasha

    1   Internal Medicine Department, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo, Egypt

  • A. Altonbary

    2   Mansoura University, Mansoura, Egypt

  • M. akram

    3   Ahmed Maher Teaching Hospital, Cairo, Egypt

  • K. Ragab

    4   Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Cairo, Egypt

  • E. Ghoneem

    5   Gehan st, Mansoura, Egypt

  • T. A. Mohammed

    6   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Qena, Egypt

  • A. Abdellatef

    7   Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini, Cairo, Egypt

  • M. Sherif Naguib

    8   Department of Gastroenterology, Ahmed Maher Teaching Hospital, Cairo, Egypt

  • Z. Hassan

    9   Department of Medicine, Stockport Hospital NHS Foundation Trust, Hazel Grove, United Kingdom

  • B. Miutescu

    10   Department of Gastroenterology and Hepatology, “Victor Babes” , Timișoara, Romania
    11   Department of Gastroenterology, "Victor Babes" University of Medicine and Pharmacy, Timișoara, Romania

  • E. Gadour

    12   King Abdulaziz Hospital, Al Mubarraz, Saudi Arabia
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Aims EUS-RFA and EUS-EA are emerging novel methods for managing non-functioning and functioning pNET and adenocarcinoma in the pancreas. We aim to assess the safety profile, feasibility, and outcomes of EUS-RFA and EUS-EA of focal pancreatic masses.

Methods This prospective study included 27 patients, 15 males and 12 females, with a mean age of 36.38 years. EUS-RFA was carried out in 13 patients; 11 had pancreatic insulinoma, and 2 had advanced pancreatic adenocarcinoma. The mean size of the masses was 20.6 mm, while that of the insulinomas was 17.4 mm. The median of the needle passes was 3, with a range of 1 to 6 passes. RFA was conducted using 19G EUSRA needles from Taewoong Co., Ltd., South Korea. No minor or major complications were observed. EUS-EA was carried out in 14 patients, all of whom had pancreatic insulinoma. The mean size of the masses was 15.3 mm. The median of the needle passes was 2, with a range of 1 to 3 passes. We used 19G and 22G echo tip FNA needles from Cook Company, USA. The mean duration of follow-up was 12.4 months. There was mild to moderate chronic pancreatitis in 4 patients in the EUS-EA group; all were relieved by conservative therapy, and no hospital admission was required. No early or late significant complications were reported in the EUS-RFA group. [1]

Results There was a complete clinical cure of 10 out of 11 (91%) patients with pancreatic insulinoma who underwent EUS-RFA. However, one patient required three sessions, and two patients required two sessions of EUS-RFA. The 11th patient with insulinoma showed poor response after the first session, then partial response after the second session of EUS-RFA. The size of the two masses with advanced adenocarcinoma was decreased, but no downstaging of the masses was achieved. There was a complete clinical cure of 8 out of 14 (57%) patients with pancreatic insulinoma who underwent EUS-EA. No clinical cure was observed in 4 patients; 3 underwent major surgery, and the 4th one underwent EUS-RFA. The last two patients showed partial clinical response with decreased frequency, duration, and severity of hypoglycemic attacks. They were managed by diet regulation; no major surgery was needed.

Conclusions EUS-RFA and EUS-EA can potentially treat lesions and control symptoms. EUS-RFA is a more promising and safer technique for managing functioning insulinomas. However, it can not downstage PDAC patients. EUS-EA seems less efficient, with more adverse events than EUS-RFA.


Conflicts of interest

Authors do not have any conflict of interest to disclose.


Publication History

Article published online:
15 April 2024

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