EUS-Guided Pancreatic Cyst Ablation
The management of pancreatic cystic lesions is often a challenge because surgical intervention can be difficult and associated with serious risks. Often, the patients are elderly and may not tolerate a pancreatic resection, such as a Whipple. Pancreatic cyst ablation therapy may provide an alternative to surgical intervention by providing a minimally invasive approach for cyst eradication. Initial approaches in cyst ablation used ethanol lavage with long-term success rates of about 50%. More recently, taxol injection has been added to ethanol lavage and higher rates of ablation have been seen. Although complication rates are low, new protocols have demonstrated greater safety eliminating ethanol and using a combination of paclitaxel and gemcitabine as ablative agents. Future studies will need to determine long-term outcomes of ablation therapy in randomized controlled trials.
KeywordsPancreatic cysts Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Pancreatic adenocarcinoma Pancreatic cyst ablation therapy EUS-guided pancreatic cyst ablation
Linear EUS video of ethanol injection of a small pancreatic cystadenoma (MP4 11207 kb)
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