title: Ethanol lavage of 14 mucinous cysts of the pancreas: A retrospective study in two tertiary centers.
abstract: BACKGROUND
  Mucinous cysts are lesions with malignant potential. Their management is stil difficult. Ethanol lavage under EUS can be used and could be a good alternative treatment. We report a bi-center experience of ethanol lavage in mucinous cysts of the pancreas.
  
  
  METHODS
  A total of 13 patients in 2 tertiary centers (7 men, 6 women, mean age=68.5 years) underwent ethanol lavage for mucinous cysts under endoscopic ultrasound (EUS) from 2001 to 2010. One of the patients had 2 cysts treated during the same procedure. One patient underwent a second procedure of ethanol lavage. Mucinous cyst diagnosis required: (1) EUS showing cystic lesion without nodule and without communication with pancreatic branch duct. Six cysts were located in the isthmus of the pancreas, 3 in the head, 3 in the body, and 2 in the tail. The mean size was 24 mm (11-50); and (2) Intra-cystic ACE level >400 UI/l and/or histologic proof. Diagnosis of mucinous cyst was obtained using ACE levels in 5 cases, histology in 8 cases, and both in 1 case.
  
  
  RESULTS
  No complication was reported. Complete responses were observed in 11 cases (85%), with no responses in 2 cases (15%). Mean follow-up was 26 months (4-118 months). Contact was lost with 1 patient. No recurrence was noticed in patients with complete responses.
  
  
  CONCLUSIONS
  This study confirms the feasibility and effectiveness of a loco-regional treatment under EUS for pancreatic cysts. The good ratio of response is probably explained by the lack of septa and the small size of the cysts. The follow-up is still short and needs to be increased. Nethertheless loco-regional treatment of pancreatic cysts lesions under EUS should form a part of the management of pancreatic lesions.
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Caillol
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poincloux
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Bories
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Emanuelle
authors.initials: E
authors.lastname: Cruzille
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Pesenti
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Darcha
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Flora
authors.initials: F
authors.lastname: Poizat
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Monges
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Bommelaer
authors.affiliation: Paoli Calmette Institute Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
keywords: endoscopic ultrasound; ethanol lavage; mucinous cyst; therapeutic endoscopic ultrasound