EUS-Guided Pancreatic Cyst Ablation: a Clinical and Technical Review

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Pancreatic cystic lesions represent a growing public health dilemma, particularly as our population ages and cross-sectional imaging becomes more sensitive. Mucinous cysts carry a clinically significant risk of developing pancreatic cancer, which carries an extremely poor prognosis. Determining which cysts will develop cancer may be challenging, and surgical resection of the pancreas carries significant morbidity. The goal of this paper is to review the rationale for cyst ablation and discuss prior and current research on cyst ablation techniques and efficacy. Indications, contraindications, and factors related to optimal patient selection are outlined. Recent Findings: Endoscopic ultrasound-guided chemoablation of pancreatic cysts has been performed in neoplastic cysts, with varying levels of efficacy. Safety concerns arose due to the risk of pancreatitis in alcohol-based treatments; however, the most recent data using a non-alcohol chemoablation cocktail suggests that ablation is effective without the need for alcohol, resulting in a significantly more favorable adverse event profile. Summary: Endoscopic ultrasound-guided chemoablation of neoplastic pancreatic cysts is a promising, minimally invasive approach for treatment of cysts, with recent significant advances in safety and efficacy, suggesting that it should play a role in the treatment algorithm.

Original languageEnglish (US)
Article number19
JournalCurrent gastroenterology reports
Volume21
Issue number5
DOIs
StatePublished - May 1 2019

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Pancreatic Cyst
Cysts
Alcohols
Ablation Techniques
Safety
Pancreatic Neoplasms
Pancreatitis
Patient Selection
Pancreas
Public Health
Morbidity
Research
Population

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

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title = "EUS-Guided Pancreatic Cyst Ablation: a Clinical and Technical Review",
abstract = "Purpose of Review: Pancreatic cystic lesions represent a growing public health dilemma, particularly as our population ages and cross-sectional imaging becomes more sensitive. Mucinous cysts carry a clinically significant risk of developing pancreatic cancer, which carries an extremely poor prognosis. Determining which cysts will develop cancer may be challenging, and surgical resection of the pancreas carries significant morbidity. The goal of this paper is to review the rationale for cyst ablation and discuss prior and current research on cyst ablation techniques and efficacy. Indications, contraindications, and factors related to optimal patient selection are outlined. Recent Findings: Endoscopic ultrasound-guided chemoablation of pancreatic cysts has been performed in neoplastic cysts, with varying levels of efficacy. Safety concerns arose due to the risk of pancreatitis in alcohol-based treatments; however, the most recent data using a non-alcohol chemoablation cocktail suggests that ablation is effective without the need for alcohol, resulting in a significantly more favorable adverse event profile. Summary: Endoscopic ultrasound-guided chemoablation of neoplastic pancreatic cysts is a promising, minimally invasive approach for treatment of cysts, with recent significant advances in safety and efficacy, suggesting that it should play a role in the treatment algorithm.",
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EUS-Guided Pancreatic Cyst Ablation : a Clinical and Technical Review. / Moyer, Matthew; Maranki, Jennifer; DeWitt, John M.

In: Current gastroenterology reports, Vol. 21, No. 5, 19, 01.05.2019.

Research output: Contribution to journalReview article

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