New treatment for cystic tumors of the pancreas: EUS-guided ethanol lavage with paclitaxel injection.
BACKGROUND
Cystic tumors of the pancreas are frequently detected and encompass a wide pathologic spectrum, ranging from benign to malignant. A substantial proportion of cystic tumors cannot be histologically classified, even after extensive diagnostic evaluation, and, therefore, ultimately require surgical resection. Recently, complete resolution of cystic tumors by EUS-guided ethanol lavage was reported in a pilot study.


OBJECTIVE
The aim of this study was to evaluate the safety, feasibility, and response after EUS-guided ethanol lavage with paclitaxel injection (EUS-EP) for cystic tumors of the pancreas.


METHODS
A prospective study.


METHODS
A tertiary care, academic medical center, from July 2005 to November 2006.


METHODS
Fourteen patients who underwent EUS-EP were observed for more than 6 months. They were analyzed in terms of procedure safety, feasibility, and response.


METHODS
EUS-EP.


METHODS
To compare changes of cyst volume before and after an EUS-EP.


RESULTS
An EUS-EP was successfully performed in all cases except one patient in whom the cyst fluid was so viscous that it could not be sufficiently aspirated. Acute pancreatitis occurred in one patient, and minor complications, including hyperamylasemia (n = 6) and vague abdominal pain (n = 1), were observed. Complete resolution of a cystic tumor was observed in 11 patients and partial resolution in two patients, and a cyst persisted in one patient.


CONCLUSIONS
A small patient number, a short follow-up time, a single treatment arm.


CONCLUSIONS
EUS-EP appears to be a safe, feasible, and effective method for treating cystic tumors of the pancreas. Further studies that involve larger populations and longer follow-ups are warranted.
Oh
Hyoung-Chul
HC
Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Seo
Dong Wan
DW
Lee
Tae Yoon
TY
Kim
Ji Young
JY
Lee
Sang Soo
SS
Lee
Sung Koo
SK
Kim
Myung-Hwan
MH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D000972:Antineoplastic Agents, Phytogenic; D000431:Ethanol; D017239:Paclitaxel