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C Meyenberger

Publications and source records attributed to C Meyenberger.

At least 37 records · Page 2Linked to original sources
PubMed1997

Comparison between esophageal Wallstent and Ultraflex stents in the treatment of malignant stenoses of the esophagus and cardia.

BACKGROUND AND STUDY AIMS: Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region. MATERIALS AND METHODS: In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions. RESULTS: Reintervention procedures were necessary in 16 of the 46 Wallstent patients (six patients during an early phase) and in 22 of the 36 Ultraflex patients (13 during an early phase) (overall P = 0.022; early P = 0.018). The major complication in the Wallstent group was tumor ingrowth (12 of 35 complications), while in the Ultraflex group, it was incomplete deployment (18 of 49 complications). Incomplete stent deployment occurred more often in patients treated with Ultraflex (P = 0.01), and food impaction was more often observed in the Wallstent group (P = 0.001). In addition, in patients with Ultraflex stents, more complex reinterventions were necessary than those required with Wallstents (four vs. 13 complex reinterventions, P = 0.0046). Wallstents tended to improve dysphagia better than Ultraflex stents. CONCLUSION: Compared to Ultraflex stents, Wallstents have several significant short-term and long-term advantages in the palliative treatment of malignancy of the esophagus and cardia.

Adult↗
PubMed1997

Self-expanding metal stents in malignant esophageal obstruction: a comparison between two stent types.

OBJECTIVES: Self-expanding metal stents are a promising alternative in the palliation of malignant esophageal obstruction, but the relative value of different stent types is not well established. METHODS: During a 3-year enrollment period in four different centers, 82 consecutive patients with malignant dysphagia without tumor recurrence after surgery or esophagorespiratory fistulas received either an uncovered Wallstent (44 patients) or a knitted nitinol stent (38 patients). RESULTS: Age (median: 79 yr), sex (F:M = 33:67), dysphagia score (median: 3), Karnofsky score (median: 53), body mass index (median: 19), type of pretreatment, tumor stage, stricture length (median: 5.4 cm), and stricture location were comparable in both stent groups. After stent placement, median dysphagia score improved markedly in both groups by two points. Procedure-related mortality (16 vs 0%; p < 0.01), early complication rate (32 vs 8%; p < 0.01), and severe persistent pain after stent placement (23 vs 0%; p < 0.002) were higher in the Wallstent compared with the knitted nitinol stent group. In contrast, stent dysfunction (7 vs 32%; p < 0.005), reintervention rate (9 vs 34%; p < 0.005), and costs were lower in the Wallstent compared with the nitinol stent group. CONCLUSIONS: In malignant esophageal obstruction, both stents markedly improved dysphagia. Uncovered Wallstents seem to cause more early severe complications than knitted nitinol stents. In contrast, stent dysfunction, reintervention rate, and costs appear to be higher in the nitinol stent group.

Adult↗
PubMed1996

[Check-up at 40 years of age].

A chest radiograph performed on a 40-year-old patient revealed a smoothly contoured right posterosuperior opacity. CT scans demonstrated a sharply defined homogeneous mass without enhancement. In a transbronchial FNA specimen, ciliated cells were found. Transesophageal ultrasound showed a hypoechoic structure, distinct from the esophagus. The patient underwent surgical excision. The postoperative finding confirmed the diagnosis of a bronchogenic cyst.

Adult↗
PubMed1996

[Tumor staging and follow-up care in rectosigmoid carcinoma: colonoscopic endosonography compared to CT, MRI and endorectal MRI].

BACKGROUND AND STUDY AIMS: Endosonography has become the best available method for local staging of primary rectal cancer and diagnosing recurrent local tumor. The aim of this prospective study is to compare the accuracy of endoscopic ultrasound (EUS), using an echo colonoscope (CF-UM 3, CF-UM 20, Olympus optical) to computed tomography (CT), body coil magnetic resonance imaging (MRI) and endorectal coil magnetic resonance imaging (EMRI). PATIENTS AND METHODS: From February 1991 to July 1993 90 patients with primary rectosigmoidal tumors (n = 32: 9 women, 23 men, mean age 68 years [range 37 to 84]) or follow-up examinations for recurrent local cancer (patients: n = 58, examinations: n = 93; 41 women, 52 men, mean age 61 years [range 31 to 84]) were investigated. The results of preoperative examinations were compared to histopathological findings regarding T and N stages. RESULTS: In T staging, accuracy of EUS (78%) was superior to CT (50%) and equivalent to both MRI (75%) and EMRI (80%). The accuracy of EUS (84%) in assessing transmural tumor infiltration was superior to CT, MRT and EMRT (50%, 75% and 80%, resp.); however, CT (77%) and MRI (86%) were more accurate than EUS (64%) and EMRI (33%) in assessing N stages. Recurrent local cancer was found in 22 patients. All but one were detected by EUS. Sensitivity, specificity and accuracy in follow-up examinations for recurrent disease for EUS were 95%, 94% and 95%, for CT 75%, 73% and 74%, for MRI 57%, 100% and 70%, and for EMRI 83%, 100% and 90% resp. CONCLUSIONS: Endoscopic ultrasound proved to be a safe and accurate method of preoperative staging and early diagnosis of recurrent rectal cancer and was superior or at least equivalent to CT, MRI and EMRI.

Adult↗
PubMed1996

[Effectiveness of triple therapy to eradicate H. pylori in patients after failed therapy with omeprazole/amoxicillin].

Helicobacter pylori (H. pylori) eradication rates with omeperazole/amoxicillin range from 0-90%. The best regimen for retreatment after failure of omeprazole/amoxicillin has not been established so far. The aim of this prospective study was to evaluate the efficacy of triple therapy with bismuth, tetracycline and ornidazole in eradicating H. pylori after failure of omeprazole/amoxicillin. 79 duodenal ulcer patients with H. pylori infection were treated with oral omeprazole (40 mg bid) and amoxicillin solute (750 mg tid) for 10 days. Eradication rate was 28/79 (35%) and was distinctly lower in smokers (> 10 cigarettes/day) vs nonsmokers (10/49 [20%] vs 18/30 [60%], p < 0.001). 37 patients with persistent H. pylori infection in whom omeprazole/amoxicillin had failed agreed to retreatment with triple therapy. Persistence of H. pylori was confirmed by histology (3 antral and 2 gastric body biopsies; H&E, Giemsa), urease test (CLO) and/or H. pylori culture. Patients smoking > 10 cigarettes/day were classified as smokers. Retreatment consisted of oral bismuth-subcitrate 4 x 120 mg/d for 28 days (day 1-28), tetracycline 4 x 500 mg/d and ornidazole 3 x 500 mg/d for 10 days (day 1-10). Control endoscopy was done 30 days after the end of treatment. Criteria for H. pylori eradication was negative urease test, culture and histology. 34/37 patients (6 females/28 males; 39 [23-64] years) completed the study (24/34 smokers, 10/34 nonsmokers). 3/37 patients dropped out because of side effects (n = 1) or incompliance (n = 2). H. pylori subcultures for resistance testing were possible in 32/34 patients: H. pylori was metronidazole-sensitive in 11/32 (1 female, 10 males; 38 [24-55] years; 9 smokers, 2 nonsmokers) and metronidazole-resistant (minimal inhibitory concentration for metronidazole > 8 mg/ml) in 21/32 (5 females, 16 males; 40 [23-64] years; 13 smokers, 8 nonsmokers). The overall H. pylori eradication rate of the triple therapy was 27/34 (79%). H. pylori was eradicated in 19/24 (79%) smokers and in 8/10 (80%) nonsmokers. Eradication rate for metronidazole-sensitive H. pylori was 11/11 (100%) vs 14/21 (67%) for metronidazole-resistant H. pylori (p = 0.012). Triple therapy is effective and safe in eradicating H. pylori in patients after failure of omeprazole/amoxicillin. Smoking had no negative effect on the eradication rate of the triple therapy after failure of omeprazole/amoxicillin. Eradication failures were due to metronidazole-resistance.

Adult↗
PubMed1996

Azygos blood flow: phase contrast quantitation in volunteers and patients with portal hypertension pre- and postintrahepatic shunt placement.

Flow volume in the azygos venous system was quantitated with Cine-phase contrast (PC) velocity mapping in volunteers and compared with patients with known portal hypertension, who were referred for transjugular intrahepatic portosystemic shunt (TIPS) placement. Subsequently, the TIPS-induced hemodynamic effects on portal and azygos flow were analyzed. To assess intra- and intersubject variability, flow in the azygos veins was measured in each of 10 normal subjects at three different times. Subsequently, portal and azygos flow was quantitated in 20 patients with portal hypertension, before and after TIPS placement. All imaging was performed on a 1.5-tesla magnetic resonance imaging (MRI) system. Azygos flow was measured transaxially at the midthoracic level. Cine-PC flow measurements of the main portal vein followed morphological evaluation of the portal venous system with axial and coronal breath-held magnet resonance angiogram. Azygos flow in normal subjects was characterized by high inter- and low intrasubject variability. Azygos flow in patients with portal hypertension was significantly higher (P < .001). Following successful TIPS placement in 18 patients, Cine-PC revealed a mean decrease in azygos flow of 46.3% (P < .001) and a 134% (P < .001) increase of portal flow. Reflecting the complexity of portal hemodynamics, there was no correlation between the changes in the portal and azygos systems. In 2 patients with early occlusion of TIPS, documented invasively, portal and azygos flow values remained largely unchanged. Cine-PC enables the noninvasive, quantitative assessment of flow within the azygos venous system. Azygos flow was found to be markedly elevated in patients with portal hypertension. Combined portal and azygos PC flow measurements quantitate the therapeutic effect of TIPS placement.

Adult↗
PubMed1996

Anal sphincter defects in fecal incontinence: correlation between endosonography and surgery.

BACKGROUND AND STUDY AIMS: Endoscopic ultrasound provides accurate information about the anatomy of the anal sphincter. The purposes of this study were to evaluate the use of flexible echo endoscopes to examine the anal sphincters, to validate the diagnosis of internal and external sphincter defects obtained using echo endoscopes by comparison with surgical findings, and to assess the outcome after surgical sphincter repair. PATIENTS AND METHODS: Twenty-eight patients (13 women, 15 men, median age 50 years, range 30-83) with fecal incontinence--which was of traumatic origin in all but one (childbirth: n = 8; anorectal surgery: n = 17; biopsy of the prostate: n = 2; no trauma: n =1)--were prospectively investigated by endosonography using an echo colonoscope (n = 14) or an echo gastroscope (n = 14) (CF-UM20, GF-UM20, Olympus Optical). The location and extent of the defects of the internal or external sphincters, or both, were compared with the surgical findings in all patients. The surgical outcome was defined as excellent, improved, or unchanged. RESULTS: At surgery, 25 of the 28 patients had an isolated internal sphincter defect (n = 15) or combined sphincter defect (n = 10). Endoscopic ultrasound identified all of the external anal sphincter defects (n = 10), and correctly excluded a defect in 15 of 18 patients (sensitivity, specificity, and accuracy 100%, 83% and 89%, respectively). All of the internal sphincter defects (n = 25) were detected by endosonography. In three patients, a postulated intact internal sphincter was confirmed by surgery (accuracy 100%). In two patients, the extent of the sphincter defect was underestimated. Despite good visualization of the internal and external anal sphincters, as well as of the puborectal muscle in all patients, the shape, diameter, and full radial image sector (360 degrees) of the echo gastroscope made this instrument more practicable than the echo colonoscope. Nineteen of 25 patients who underwent surgery (76%) with proved sphincter defects experienced improvement, the figure reaching 87% (13 of 15) in patients who received isolated internal sphincter defect repair. CONCLUSIONS: Anal endosonography, even using flexible echo endoscopes, is an accurate method for identifying anal sphincter defects, and is the method of choice for preoperative sphincter mapping with special regard to internal sphincter repair, which can be carried out with excellent results.

Adult↗
PubMed1996

Long-term follow-up after treatment of common bile duct stones by extracorporeal shock-wave lithotripsy.

BACKGROUND AND STUDY AIMS: The efficacy of extracorporeal shock-wave lithotripsy (ESWL) of difficult bile duct stones that were not amenable to routine endoscopic extraction was assessed, with evaluation of the long-term follow-up after successful treatment. PATIENTS AND METHODS: Fifty-four patients (mean age 74 years, range 33-92) were treated with ESWL for difficult bile duct stones. Treatment was performed either with the Dornier HM3 kidney lithotriptor (49 patients) or with the MPL 9000 lithotriptor (five patients). RESULTS: Stone disintegration was achieved in 50 patients (93%), with complete stone clearance in 45 patients (83%) (mean 1.2 session). Patients with successful stone removal after one session had significantly smaller stones than patients with treatment failure (20 +/- 9 versus 27 +/- 8 mm; p < 0.05). An intrahepatic location of stones was significantly associated with treatment failure (p < 0.005). Serve complications occurred in 7% (procedure-related 5%), with a 30-day mortality rate of 0% (in-hospital mortality rate of 2%). Minor side effects such as fever, petechiae, and mild arrhythmias were frequent (37%), and microhematuria (95%) occurred in nearly all of the patients. Symptomatic recurrent bile duct stones were observed in two patients (5%) after three and four years, respectively (mean follow-up 5.3 years). CONCLUSION: Extracorporeal shock wave lithotripsy represents a safe and effective treatment modality for difficult bile duct stones, with a low rate of symptomatic recurrences.

Adult↗
PubMed1996

Bleeding anorectal varices: successful treatment with transjugular intrahepatic portosystemic shunting (TIPS).

A patient with severe recurrent rectal bleeding from anorectal varices due to portal hypertension because of hepatitis C virus related liver cirrhosis is presented. As illustrated by the report, it is essential to differentiate bleeding anorectal varices from bleeding haemorrhoids because treatment is different. In our patient, implantation of a transjugular intrahepatic portosystemic shunt (TIPS) led to an impressive regression of the anorectal varices, which could be demonstrated by sigmoidoscopy, endosonography, and magnetic resonance imaging. Recurrent rectal bleeding in a patient with portal hypertension should alert the physician to consider anorectal varices. Endoscopic ultra-sound and magnetic resonance imaging are new and non-invasive modalities for diagnosis and post-treatment control.

Aged↗
PubMed1995

[Current therapy of esophageal varices hemorrhage].

Acute bleeding from esophageal varices is a medical emergency. It requires a structured therapeutic strategy which is adapted to the local resources. The primary goal is to stop bleeding, preferably by endoscopic sclerotherapy or ligation. In situations where endoscopic intervention is not possible as a first-line treatment, therapy with balloon tamponade or vasoactive drugs (terlipressin or octreotide) are options to be followed as soon as possible by sclerotherapy or ligation. After successful hemostasis, the next goal is to prevent rebleeding. This is achieved primarily by eradicating sclerotherapy or ligation. In special situations, long-term therapy with a non-cardio-selective beta receptor blocker is an alternative. The combined approach of sclerotherapy or ligation plus beta receptor blocker has no significant advantage. Primary prophylaxis of bleeding from esophageal varices by long-term beta receptor blocker therapy is advised in patients with medium-sized or large varices. Apart from strategies aimed at the therapy or prophylaxis of bleeding from esophageal varices, measures to prevent and treat chronic liver diseases should be implemented in order to reduce the development of liver cirrhosis as the leading cause of esophageal varices.

Adrenergic beta-Antagonists↗
PubMed1995

[Clinical manifestations and course of cytomegalovirus colitis in AIDS patients].

The clinical findings and course in 10 HIV-positive patients with cytomegalovirus (CMV) colitis were analyzed. Homosexuality was the main risk factor for HIV infection. All patients had markedly reduced CD4 counts (mean 25 x 10(9)/l). Symptoms at presentation were chronic diarrhea, weight loss, fever and abdominal pain. One of the patients had an abdominal mass in the ileocecal region due to inflammation as the leading symptom. Endoscopically the colitis was more often segmental than diffuse. In 2 out of 9 patients who underwent colonoscopy, only the right hemicolon was affected. Concurrent intestinal infections with up to 4 different pathogens were found in 7 patients. 5 patients had chorioretinitis as an extraintestinal CMV symptom (2 before, 3 after the occurrence of CMV-colitis). In only one patient was there a partial response of CMV-colitis to therapy with ganciclovir and foscarnet. Even under therapy CMV colitis was complicated in 2 patients by perforation and inflammatory stenosis respectively. Both needed surgical treatment. Most of the patients died of generalized CMV infection or wasting syndrome.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Initial personal experiences with alpha-1-antitrypsin determination in feces].

Fecal alpha-1-antitrypsin is recommended as a marker of enteric protein loss and in patients with Crohn's disease as an index of intestinal inflammatory activity. We describe our experience in 88 patients with chronic diarrhea or suspicion of protein-losing enteropathy. We measured alpha-1-antitrypsin concentration in random stool samples (n = 7), quantitative alpha-1-antitrypsin excretion in a 24 h feces collection (n = 59) and fecal alpha-1-antitrypsin clearance (n = 22). 13 of 88 patients with the following diagnoses had increased values: Crohn's disease (3/9), other inflammatory diseases of the small intestine (3/3, Whipple's disease, eosinophilic gastroenteritis, celiac disease), hypertrophic gastropathy (1/4), infectious diarrhea (2/6), irritable bowel syndrome (2/29), chronic pancreatitis (2/32) and diarrhea of other reasons (0/5). In patients with Crohn's disease, alpha-1-antitrypsin excretion correlated with the clinical disease activity. All 3 patients with other inflammatory diseases of the small intestine showed increased fecal alpha-1-antitrypsin. All but 2 of the 32 patients with diarrhea due to chronic pancreatitis had normal values. Of 29 patients with idiopathic diarrhea, only 2 showed slightly increased fecal alpha-1-antitrypsin. 10 of the 11 patients with increased alpha-1-antitrypsin excretion in 24 h stool collection had normal alpha-1-antitrypsin concentration in random stool samples. Of the 5 patients with increased alpha-1-antitrypsin clearance, 4 also had increased alpha-1-antitrypsin in 24 h stool collection, but only one had increased alpha-1-antitrypsin concentration in random stool sample. Fecal alpha-1-antitrypsin measurement proved helpful in differing between inflammatory and non-inflammatory diarrhea.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Proteins↗
PubMed1995

[Self-expanding wire-netting Elastalloy endoprosthesis in malignant esophageal stenosis].

12 patients with malignant inoperable esophageal obstruction (carcinoma of the esophagus n = 7, carcinoma of the esophagogastric junction n = 3, mediastinal lymph node metastasis n = 2) and high-grade dysphagia were treated with self-expanding metal stents (Ultraflex, Microvasive) made of a nickel titanium alloy (Elastalloy). Other forms of palliation had failed in 9/12 patients. The degree of palliation was expressed as a dysphagia score (0-4) before and after stent insertion. The stents were inserted under endoscopic and fluoroscopic control. They were placed successfully and without complications in all patients. A good functional result was achieved in 11 patients (91.7%). Thus, the dysphagia score decreased significantly from 3.2 +/- 0.4 before to 0.9 +/- 1.0 immediately after stent insertion (p < 0.001). The remarkable relief of dysphagia was sustained during a mean follow up of 101 days (10-278) with a dysphagia score of 1.1 +/- 1.0 at the end of the study (p < 0.001 compared to the score before the procedure). In one patient with mediastinal lymph node metastasis the stent expanded insufficiently. 7 days after insertion it was removed endoscopically and replaced successfully by another stent with a stronger expansive force (Instent). 3 patients experienced recurrent dysphagia (food impaction n = 1 tumor ingrowth through the meshes of the stent n = 2). They were successfully treated by an endoscopical intervention (endoscopical dilatation n = 1, laser therapy n = 1, insertion of a Wallstent n = 1). At the end of the study, 6 patients were alive, 6 patients were dead with a mean survival of 56 days (10-117).

Adult↗
PubMed1995

[Abnormal increase in pancreatic polypeptide in the secretin-provocation test: hypoglycemia-induced?].

Pancreatic polypeptide (PP) can be used as a marker for endocrine active tumors originating from the pancreas. After intravenous administration of secretin, individually divergent increases in plasma PP concentration can be observed hampering interpretation of the stimulation test. Under certain circumstances elevated basal PP concentrations can be observed. Besides age, renal insufficiency and diabetes, hypoglycemia can cause high PP levels. We therefore inquired whether in patients with atypically high increase of PP after secretin this increase could be caused by hypoglycemia during the secretin stimulation test. In order to test this hypothesis we prospectively determined the plasma glucose and insulin concentrations in addition to the routinely measured gastro-intestinal hormones in 19 patients referred for secretin provocation test. In the 16 patients in whom the increase of PP was not due to an endocrine active tumor or renal insufficiency, PP rose to 170 +/- 57 pmol/l (+/- SEM) 2 minutes after secretin administration. In parallel, plasma insulin concentration increased to 365 +/- 51 pmol/l 2 minutes after secretin. The maximal insulin concentrations correlated significantly with the PP concentrations observed at the same time (R = 0.73, p < 0.01). The mean glucose concentration, however, remained constantly between 4.8 +/- 0.3 and 5.2 +/- 0.3 mmol/l and there was no correlation between the peak plasma PP concentrations after secretin and the plasma glucose concentrations (R = 0.07). The minimal glucose concentrations observed were 3.3 mmol/l in three patients (30 minutes after secretin in 2 patients and 45 minutes after secretin in one). The mean plasma glucagon concentration rose to 22.5 +/- 4.1 pmol/l 10 minutes after secretin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Significance of subtype pattern of antimitochondrial antibodies in primary biliary cirrhosis for prognostic parameters and response to ursodeoxycholic acid].

Antimitochondrial antibodies are of considerable importance for the diagnosis of primary biliary cirrhosis. Several subtypes of antimitochondrial antibodies have been identified and the pattern has been associated with prognosis of the disease in the long term course. 22 patients with primary biliary cirrhosis (19 female, 3 male; age 29-66, mean 49 years) were examined for the occurrence of the subtypes of antimitochondrial antibodies anti M2, anti M4 and anti M9. Diagnosis of primary biliary cirrhosis was based on elevated cholestatic enzymes, antimitochondrial antibodies, histology and exclusion of other chronic liver disease in all patients and elevated serum IgM concentration in 18/22 patients. Most patients were included in a study protocol of the Swiss Association for the Study of the Liver and treated with 10 mg/kg/day oral ursodeoxycholic acid. According to the subtype pattern of antimitochondrial antibodies, patients were divided into 4 groups A to D (A: anti M2-, anti M4-, anti M9+; B: anti M2+, anti M4-, anti M9+; C: anti M2+, anti M4-, anti M9- and D: anti M2+, anti M4+, anti M9-). The groups were compared with respect to the prognostically relevant parameters age, bilirubin, albumin, prothrombin time and peripheral edema, as well as the occurrence of granulomas in liver biopsy, galactose elimination capacity and response to treatment with ursodeoxycholic acid during one year. Treatment response was expressed as decrease of the serum concentration of IgM, GPT, alkaline phosphatase, gamma glutamyl transpeptidase and bilirubin. No significant differences between the four groups were found with respect to the prognostically relevant parameters, histology and galactose elimination capacity at study entry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Endosonography in diagnosis of insulinoma].

AIM: In a prospective study endoscopic ultrasonic localisation of clinically suspected insulinomas was compared with the findings of abdominal ultrasound, computed tomography and magnetic resonance imaging. METHOD: From Dec. 1990 to Jan. 1995 11 patients (8f, 3m, median age 42 [27-79] years) were enrolled in the study. The preoperative endosonographic findings were compared to surgery (n = 7) or clinical follow-up (n = 4). RESULTS: Endoscopic ultrasound identified a solitary tumour (mean size 12.4 mm) in 7 of 11 patients, which was proven at surgery in 5 patients and by transhepatic portal venous sampling after negative partial pancreas resection in 1 patient. One patient is still awaiting surgery. Clinical follow-up (n = 2) and negative intraoperative and histological findings of partial pancreas resection (n = 1) confirmed a true negative examination in 3 patients. One patient with negative endoscopic ultrasound is still under medication for recurrent hypoglyctemia. Abdominal ultrasound (n = 11), computed tomography (n = 11) and magnetic resonance imaging (n = 5) were negative in all investigated patients. CONCLUSION: Endoscopic ultrasound is highly accurate for localisation of insulinomas and should be performed early in the preoperative management of these patients.

Adult↗