Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Oct 16, 2026; 18(10): 125918
Published online Oct 16, 2026. doi: 10.4253/wjge.125918
Published online Oct 16, 2026. doi: 10.4253/wjge.125918
Endoscopic ultrasound-guided ablation of small pancreatic neuroendocrine neoplasms: Bridging the gap between surveillance and surgery
Sara Massironi, Giuseppe Dell'Anna, Paolo Biamonte, Francesca Bernardi, Silvio Danese, Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan 20132, Lombardy, Italy
Giuseppe Dell'Anna, Department of Gastroenterology and Digestive Endoscopy, IRCCS Ospedale San Raffaele, Milan 20132, Lombardy, Italy
Giuseppe Dell'Anna, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese 20097, Lombardy, Italy
Paolo Biamonte, Francesca Bernardi, Unit of Gastroenterology, Ospedale Maggiore della Carità di Novara, Novara 28100, Piedmont, Italy
Silvio Danese, Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan 20132, Lombardy, Italy
Author contributions: Massironi S conceived and designed the review, supervised the project, critically interpreted the literature, and drafted and revised the manuscript; Dell’Anna G performed the literature search, contributed to data collection and interpretation, and drafted and revised the manuscript; Biamonte P and Bernardi F contributed to literature review, data interpretation, and critical revision of the manuscript; Danese S provided scientific supervision, contributed to interpretation of the evidence, and critically revised the manuscript for important intellectual content; all authors reviewed and approved the final version of the manuscript and agree to be accountable for all aspects of the work.
AI contribution statement: During revision of the manuscript, OpenAI’s ChatGPT was used to assist with English-language editing and stylistic refinement. All scientific content, interpretations, references, figure structure, labels, and final wording were critically reviewed and approved by the authors, who take full responsibility for the manuscript. The tool was not used to generate original data, perform statistical analyses, select references autonomously, or determine scientific conclusions.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Sara Massironi, Associate Professor, Department of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina 56, Milan 20132, Lombardy, Italy. sara.massironi@libero.it
Received: July 21, 2026
Revised: July 29, 2026
Accepted: September 4, 2026
Published online: October 16, 2026
Processing time: 86 Days and 14.7 Hours
Revised: July 29, 2026
Accepted: September 4, 2026
Published online: October 16, 2026
Processing time: 86 Days and 14.7 Hours
Core Tip
Core Tip: Small pancreatic neuroendocrine neoplasms pose a therapeutic dilemma because surveillance may expose selected patients to tumor progression and psychological burden, whereas pancreatic surgery carries substantial morbidity. Endoscopic ultrasound-guided ethanol injection and radiofrequency ablation offer a pancreas-preserving intermediate strategy. This review summarizes current techniques, clinical outcomes, safety considerations, and proposed selection criteria, emphasizing that endoscopic ultrasound-guided ablation should currently be reserved for carefully selected patients treated in expert multidisciplinary centers.