title: Advanced endoscopic ultrasound management techniques for preneoplastic pancreatic cystic lesions.
abstract: Pancreatic cystic lesions can be benign, premalignant or malignant. The recent increase in detection and tremendous clinical variability of pancreatic cysts has presented a significant therapeutic challenge to physicians. Mucinous cystic neoplasms are of particular interest given their known malignant potential. This review article provides a brief but comprehensive review of premalignant pancreatic cystic lesions with advanced endoscopic ultrasound (EUS) management approaches. A comprehensive literature search was performed using PubMed, Cochrane, OVID and EMBASE databases. Preneoplastic pancreatic cystic lesions include mucinous cystadenoma and intraductal papillary mucinous neoplasm. The 2012 International Sendai Guidelines guide physicians in their management of pancreatic cystic lesions. Some of the advanced EUS management techniques include ethanol ablation, chemotherapeutic (paclitaxel) ablation, radiofrequency ablation and cryotherapy. In future, EUS-guided injections of drug-eluting beads and neodymium:yttrium aluminum agent laser ablation is predicted to be an integral part of EUS-guided management techniques. In summary, International Sendai Consensus Guidelines should be used to make a decision regarding management of pancreatic cystic lesions. Advanced EUS techniques are proving extremely beneficial in management, especially in those patients who are at high surgical risk.
authors: Department of Internal Medicine, University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, Illinois, USA.
authors: Hafiz Muhammad Sharjeel
authors: HM
authors: Arshad
authors: Department of Gastroenterology, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Sheila
authors: S
authors: Bharmal
authors: Department of Gastroenterology, Marmara University, Istanbul, Turkey.
authors: Deniz Guney
authors: DG
authors: Duman
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: Suthat
authors: S
authors: Liangpunsakul
authors: Ohio Gastroenterology Group, Columbus, Ohio, USA.
authors: Brian G
authors: BG
authors: Turner
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D019160:Endosonography; D006801:Humans; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D011230:Precancerous Conditions / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: Endoscopy; Pancreatic Carcinoma; Pancreatic Diseases; Pancreatic Neoplasms