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The mobile phase consisted of a linear gradient system of phase A (60% acetonitrile/40% water solution containing 10 mM ammonium acetate and 0.1% formic acid) and phase B (isopropanol:acetonitrile, 9:1, v/v): 0 min 60% A, 2 min 57% A, 12 min 40% A, 12.1 min 25% A, 18 min 1% A, 19 min 1% A, and 20 min 40% A

The feedback inhibition of IGF-1 on further GH secretion stayed intact, preventing the GH excess that drives insulin resistance with direct injection

The patient and surgeon discussed the implications, risks, and options given the gastric POCUS findings