The Comparison Between Endoscopic Ultrasound (EUS)-Guided Ethanol Ablation And Surgical Treatment Of Benign Insulinoma:A Clinical Research

Objective To evaluate the safety and efficacy of EUS-guided ethanol ablation of benign insulinoma and Compare advantages and disadvantages with surgical treatment.Methods From April 2011 to February 2016, the clinical data of 38 patients with benign insulinoma treated by endoscopic ultrasound-guided ethanol ablation or surgical treatment at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.Results 97.4%(37/38) patients had a typical clinical manifestation of Whipple's triad,And the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75%, 89.7% respectively .In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgical treatment(surgical group). Compared with the surgical group,the operation time , intraoperative hemorrhage volume , postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40% ( 8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90% (18/20) patients had no recurrence, Episode of hypoglycemia was less after the operation in 10% (2/20) patients.Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, Compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.