%0 Journal Article
%T Endoscopic ultrasound-guided radiofrequency ablation of pancreatic insulinoma: a state of the art review.
%A Dhar J
%A Samanta J
%A Nabi Z
%A Aggarwal M
%A Facciorusso A
%A Conti Bellocchi MC
%A Crinò SF
%J Expert Rev Gastroenterol Hepatol
%V 18
%N 1
%D 2024 Jan-Feb 4
%M 38383965
%F 4.095
%R 10.1080/17474124.2024.2321938
%X <B>UNASSIGNED: </B>Insulinomas are the most common functional pancreatic neuroendocrine tumors (PNETs) that lead to incapacitating hypoglycemia. Guidelines recommend surgical resection as the mainstay of management. However, surgery is fraught with complications, causing significant peri/post-operative morbidity. Since insulinomas are usually benign, solitary, small (<2 cm), and do not need lymphadenectomy, hence, in this regard, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is now being increasingly performed, to circumvent these adverse events and impairment of pancreatic function.<BR><B>UNASSIGNED: </B>A comprehensive literature search was undertaken across various databases (PubMed/MEDLINE, Embase, Scopus), with no language restriction, for relevant articles (case series, reviews, case reports) pertaining to EUS-RFA for insulinoma and PNETs, till October 2023. In this review, we have explicated the role of EUS-RFA for insulinoma management, detailing thoroughly its mechanism of action, EUS-RFA devices with data on its safety and efficacy, and an algorithmic approach for its management.<BR><B>UNASSIGNED: </B>EUS-RFA is being advocated as a 'mini-invasive' option with the potential to replace surgery as a first-line approach for benign, sporadic, solitary, and small (<2 cm) insulinomas. Under real-time guidance, EUS-RFA has immense precision, is safe, predictable, with acceptable safety profile. Presently, it is being frequently performed for high-risk or inoperable candidates. Current need-of-the-hour is a randomized controlled trial to substantiate its role in the therapeutic algorithm for insulinoma management.