Endoscopic ultrasound-guided ablation is a promising treatment for pancreatic cystic neoplasms - a systematic review.

Abstract

INTRODUCTION:

With the increasing use of cross-sectional imaging, the incidence of non-symptomatic pancreatic cystic neoplasms is increasing. Surgical management of pancreatic cystic neoplasms possess significant risks of perioperative morbidity and mortality. Our aim was to evaluate endoscopic ultrasound (EUS)-guided ablation as a non-operative treatment of pancreatic cystic neoplasms.

METHODS:

We performed a literature search in MEDLINE, Embase and Scopus. All clinical studies examining the safety and efficacy of EUS-guided pancreatic cyst ablation with radiofrequency, sclerosants, ethanol, chemotherapeutics or a combination hereof were included.

RESULTS:

A total of 17 studies were included. We found that EUS-guided pancreatic cyst ablation was feasible with complete resolution in up to 86% of cases after 3-12 months. The modality with the most promising results after 3-12 months was chemoablation with complete resolution rates ranging from 46 to 79% (median 64%). The most appropriate follow-up period was estimated to be 12 months. The risk of serious adverse events including pancreatitis was approximately 16%. Very few cyst recurrences have been documented following complete resolution after cyst ablation.

CONCLUSIONS:

EUS-guided cyst ablation of pancreatic cystic lesions seems effective and safe as an alternative to surgical resection in patients who are unfit for surgery or who have low-risk pancreatic cystic neoplasms.

• Authors: Gitte Aabye Olsen, Lisa Aalling, John Gásdal Karstensen
• Journal: Danish medical journal (Dan Med J) Vol. 67 Issue 8 (Aug 01 2020) ISSN: 2245-1919 [Electronic] Denmark
• PMID: 32741440 (Publication Type: Journal Article, Systematic Review)
• Copyright: Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Topics

• Ablation Techniques (methods)
• Adult
• Clinical Trials as Topic
• Endosonography (methods)
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Cyst (surgery)
• Pancreatic Neoplasms (surgery)
• Prospective Studies
• Retrospective Studies
• Treatment Outcome
• Ultrasonography, Interventional (methods)