title: Ethanol lavage of pancreatic cystic lesions: initial pilot study.
abstract: BACKGROUND
  Ethanol lavage has been used to successfully and safely ablate cystic lesions of the liver, the kidneys, and the thyroid.
  
  
  METHODS
  Asymptomatic patients who undergo EUS examination for a pancreatic cystic lesion were eligible. Patients underwent complete examination with a linear-array echoendoscope, and cyst characteristics were documented. After evacuation of the cyst with needle aspiration, the cyst cavity was lavaged with ethanol for 3 to 5 minutes. The concentration (5%-80%) of ethanol was gradually increased over the course of the study. Patients were monitored for complications during 2 hours after the procedure, and further follow-up was obtained at 72 hours and 1 year after lavage.
  
  
  METHODS
  Twenty-five patients were enrolled, 80% were women, and the mean age of all patients was 64.5 years. Cysts had a mean diameter of 19.4 mm and were equally located in the head, the body, and the tail of the pancreas. Cyst-fluid characteristics included high viscosity in 13 (52%) and a mean carcinoembryonic antigen and amylase of 5916 ng/mL and 11,506 U/L, respectively. None of the patients reported any symptoms in short- and long-term follow-up. Of the 23/25 patients with complete follow-up, 8 patients (35%) had complete resolution of their cysts on follow-up imaging. Five patients underwent resection, and histologic evidence of epithelial ablation was seen.
  
  
  CONCLUSIONS
  Ethanol lavage of pancreatic cystic lesions is safe and feasible. A subset of patients undergoing ethanol lavage appears to have long-term resolution on follow-up imaging. Further prospective studies are required to determine if ethanol lavage is an effective treatment for pancreatic cystic lesions.
authors.affiliation: Gastrointestinal Unit, Department of Pathology, Massachusetts General Hospital, Boston, 02114, USA.
authors.forename: S Ian
authors.initials: SI
authors.lastname: Gan
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Thompson
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Brenna C
authors.initials: BC
authors.lastname: Bounds
authors.forename: William R
authors.initials: WR
authors.lastname: Brugge
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D019160:Endosonography; D000431:Ethanol / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012449:Safety; D013396:Suction / Q000379:methods; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol