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Endoscopic ultrasound-guided ethanol ablation of pancreatic cystic neoplasia


Authors: M. Kliment 1;  O. Urban 1,2;  D. Žiak 3;  P. Fojtík 1;  Přemysl Falt 1;  J. Dvořáčková 2,4
Authors‘ workplace: Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava, 2Lékařská fakulta ostravské univerzity, Ostrava, 3CGB Laboratoř, Patologie, Ostrava, 4Patologie, Fakultní nemocnice Ostrava 1
Published in: Gastroent Hepatol 2012; 66(3): 183-186
Category: Digestive Endoscopy: Video-Case Report

Overview

Endoscopic ultrasound-guided ethanol ablation/lavage of pancreatic cystic neoplasia is a new method of local ablative treatment, when highly concentrated ethylalcohol is injected into the cyst. The principle of the method is the chemical lysis of neoplastic cells in inner lining of the cyst with subsequent regression of cystic neoplasia. Recently, the method has been used mostly in clinical trials, that have confirmed efficacy in 33–79%. The authors present a video-case report of an older patient with significant comorbidities and pancreatic cystic neoplasia, that was treated by ethanol ablation. The authors discuss hitherto published papers dealing with EUS-guided ethanol ablation of pancreatic cysts, especially the efficacy and safety of the method.

Key words:
endosonography – endoscopic ultrasound-guided ethanol ablation – ethanol lavage – pancreatic cystic neoplasia


Sources

1. Kliment M, Urban O, Čeganová L et al. EUS-FNA of pancreatic cysts-the yield of cytological, biochemical and molecular analysis of cyst fluid aspirate in diagnosing pancreatic cystic neoplasia. Endoscopy 2011; 43 (Suppl I): A124.

2. Xiao YY, Tian JL, Li JK et al. CT-guided percutaneous chemical ablation of adrenal neoplazma. AJR Am J Roentgenol 2008; 190(1): 105–110.

3. Yang CF, Liang HL, Pan HB et al. Single-session prolonged alcohol-retention sclerotherapy for large hepatic cysts. AJR Am J Roentgenol 2006; 187(4): 940–943.

4. Gelzer RK, Charboneau JW, Hussain S et al. Complications of percutaneous ethanol ablation. J Ultrasound Med 1998; 17(8): 531–533.

5. Yamamoto S, Miyake I, Takatori K et al. Percutaneous ethanol injection for unresectable pancreatic cancer-report of two cases. Gan To Kagaku Ryoho 1998; 25:  1969–1971.

6. Allen PJ, D´Angelica M, Gonen M et al. A selective approach to the resection of cystic lesions of the pankreas results from 539 consecutive patients. Ann Surg 2006; 244(4): 572–582.

7. DeWitt J, McGreevy K, Schmidt CM et al. Endoscopic ultrasound guided ethanol versus saline lavage for pancreatic cysts: a randomized double blinded study. Gastro­intest Endosc 2009; 70(4): 710–723.

8. De Witt J, DiMaio CJ, Brugge WR. Long-term follow-up of pancreatic cysts that resolve radiologically after EUS-guided ethanol ablation. Gastrointest Endosc 2010; 72(4): 862–866.

9. Matthes K, Mino-Kenudson M, Sahani DV et al. Concentration-dependent ablation of pancreatic tissue by EUS-guided ethanol injection. Gastrointest Endosc 2007; 65(2): 272–277.

10. DiMaio CJ, DeWitt JM, Brugge WR. Ablation of pancreatic cystic lesions: the use of multiple endoscopic ultrasound-guided ethanol lavage sessions. Pancreas 2011; 40(5): 664–668.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 3

2012 Issue 3

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