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Pancreas. 2011 Jul;40(5):664-8. doi: 10.1097/MPA.0b013e3182128d06.

Ablation of pancreatic cystic lesions: the use of multiple endoscopic ultrasound-guided ethanol lavage sessions.

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1
Gastroenterology and Nutrition Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. dimaioc@mskcc.org

Abstract

OBJECTIVES:

Determine the effectiveness of multiple endoscopic ultrasound-guided ethanol lavage (EUS-EL) sessions for attempted ablation of pancreatic cystic lesion (PCL).

METHODS:

Retrospective review of patients who have undergone 2 or more EUS-EL treatments of a PCL. Eligible patients had asymptomatic, benign-appearing PCL, no previous pancreatitis, and were considered poor surgical candidates.

RESULTS:

Final analysis was performed on 13 patients with suspected branch duct intraductal papillary mucinous neoplasms. The mean maximum cyst diameter at baseline and after 1 and 2 EUS-EL treatments was 20.1 ± 7.1, 17.0 ± 9.8 (P = 0.06), and 12.8 ± 9.6 mm (P = 0.0002), respectively. The mean surface area after 2 EUS-EL sessions: baseline, 5734 ± 6846 mm(2); 1 EUS-EL session, 4906 ± 9240 mm(2) (P = 0.52); and 2 EUS-EL sessions, 2311 ± 4093 mm(2) (P = 0.008). Complete resolution of the cystic lesion was not seen by computed tomography or magnetic resonance imaging in any patient after 1 EUS-EL but occurred in 5 (38%; P = 0.02) of 13 patients after 2 EUS-EL treatments. One patient had minor abdominal pain 1 day after the first EUS-EL session and 2 days after the second session.

CONCLUSIONS:

Compared with only 1 EUS-EL, 2 EUS-EL treatment results in a significantly greater decrease in the size and surface area of PCL and is associated with a significantly higher rate of image-defined cyst resolution.

PMID:
21562447
DOI:
10.1097/MPA.0b013e3182128d06
[Indexed for MEDLINE]
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