Document Detail


Ethanol lavage of pancreatic cystic lesions: initial pilot study.
MedLine Citation:
PMID:  15855986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. OBSERVATIONS: 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:
S Ian Gan; Christopher C Thompson; Gregory Y Lauwers; Brenna C Bounds; William R Brugge
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  61     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-27     Completed Date:  2005-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  746-52     Citation Subset:  IM    
Affiliation:
Gastrointestinal Unit, Department of Pathology, Massachusetts General Hospital, Boston, 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents, Local / therapeutic use*
Endosonography
Ethanol / therapeutic use*
Feasibility Studies
Female
Follow-Up Studies
Humans
Irrigation / methods
Male
Middle Aged
Pancreatic Cyst / pathology,  therapy*,  ultrasonography
Pilot Projects
Prospective Studies
Safety
Suction / methods
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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