Expert consensus on endoscopic diagnosis and treatment of insulinoma (2026)

Insulinoma is a rare functional pancreatic neuroendocrine tumor characterized by excessive insulin secretion, which causes hypoglycemia. Recent advances in endoscopic technology have provided essential tools for the diagnosis and treatment of insulinoma. Early diagnosis and timely intervention, particularly endoscopy-guided intervention in selected patients, may improve clinical outcomes and quality of life. Although existing national and international guidelines mention insulinoma, standardized criteria for its endoscopic diagnosis and treatment remain lacking. Therefore, under the leadership of the Digestive Endoscopy Branch of the Chinese Medical Association, experts from related fields were invited to develop the Expert Consensus on Endoscopic Diagnosis and Treatment for Insulinoma (2026). The development process included a comprehensive review of recent national and international evidence-based literature, with the quality of evidence and strength of recommendations assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This consensus emphasizes endoscopy-guided diagnostic and therapeutic approaches. It aims to provide practical recommendations and operational guidance for standardized endoscopic diagnosis and treatment of insulinoma, thereby advancing the quality of endoscopic care for this condition in China.