A Comparative Analysis Of Rebound Hyperglycemiaafter Endoscopic-Guided Injection Treatment(EUS-FNI)and Surgical Treatment Of Insulinoma

Objective : To compare and analyze the influencing factors of rebound hyperglycemia after endoscopic-guided injection treatment(EUS-FNI)and surgical treatment of insulinoma.Methods:The clinical data of fifty-six patients with insulinoma admitted to the First Affiliated Hospital of Guangxi Medical University from June 2006 to February 2019 were collected.The influencing factors of rebound hyperglycemia after EUS-FNI treatment and surgical treatment of insulinoma were compared and analyzed.Results : Of 56 patients with insulinoma,26 underwent endoscopic ultrasonography treatment and 30 underwent surgical treatment.According to the different treatment methods,they were divided into endoscopic ultrasonography treatment group and surgical treatment group.There was no significant difference in sex,age,size,location and number of tumors betweenthe two groups.The positive rates of preoperative localization diagnosis of insulinoma by transabdominal ultrasound,CT,MRI and EUS were 8.3%,68.9%,52.9% and 90.5%,respectively.The postoperative average blood glucose in the surgical group was significantly higher than that in the EUS group(P < 0.05).EUS group was divided into ethanol group and polidocanol group according to the injections used.In the EUS group,9 patients had rebound hyperglycemia(4patients in the ethanol group and the rest in the polidocanol group),while the surgical group had 29 patients occured rebound hyperglycemia.And the rebound hyperglycemia rate in the surgical group was significantly higher than that in the EUS group(P < 0.05).There was no significant difference in blood glucose and postoperative blood glucose rate between the ethanol group and the polidocanol group after treatment(P > 0.05).There were no complications in the EUS group,and about 20% of the patients in the surgical group had complications(P < 0.05).Conclusion:Postoperative hyperglycemia was not correlated with age,sex,location of tumors and size of tumors,but only with different treatment.The incidence of rebound hyperglycemia and postoperative complications in patients with insulinoma treated by EUS-FNI was significantly lower than that after surgery.Among them,the blood glucose in the ethanol group and the polidocanol group was stable after treatment,and the rebound hyperglycemia in the two groups was less and there was no significant difference.The efficacy ofethanol and polidocanol as different injections for the treatment of insulinoma under the guidance of endoscopic ultrasonography was similar.