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The efficacy and safety of endoscopic ultrasound-guided ablation of pancreatic cysts with alcohol and paclitaxel

a systematic review

Attila, Tana,c; Adsay, Volkanb; Faigel, Douglas O.d

European Journal of Gastroenterology & Hepatology: January 2019 - Volume 31 - Issue 1 - p 1–9
doi: 10.1097/MEG.0000000000001297
Review Article

Endoscopic ultrasound (EUS)-guided pancreatic cyst ablation with alcohol lavage or paclitaxel-based regimens are investigative modalities. To evaluate the safety and efficacy of EUS-guided pancreatic cyst ablation with alcohol lavage or paclitaxel-based regimens. A systematic review of computerized bibliographic databases was carried out for studies of EUS-guided pancreatic cyst ablation with alcohol lavage or paclitaxel-based regimens from January 1980 to February 2018. EUS-guided cyst ablation-related outcomes (cyst resolution) and complications. Data were extracted from six studies (N=207 patients) for EUS-guided cyst ablation with alcohol lavage and eight studies (N=347 patients) for EUS-guided cyst ablation with paclitaxel-based regimens. The pooled proportion of patients with complete cyst resolution was 68/207 (32.8%) for EUS-guided cyst ablation with alcohol lavage and 221/347 (63.6%) for EUS-guided cyst ablation with paclitaxel. Postablation adverse events with EUS-guided ablation with alcohol lavage were 44/207 (21.7%), and those with EUS-guided ablation with paclitaxel-based regimens were 52/347 (15%). Limitations of this study are because of the variability in study design and regimens tested, paucity of randomized trials, and differences in pancreatic cyst types receiving treatment. EUS-guided cyst ablation appears to be effective and safe. The effect on pancreatic cancer incidence is unknown; EUS-guided pancreatic cyst ablation modalities require further improvement and validation to determine their role in the treatment of patients with pancreatic cystic lesions.

aDepartment of Internal Medicine, Division of Gastroenterology and Hepatology

bDepartment of Pathology, Koc University School of Medicine

cDepartment of Internal Medicine, American Hospital, Division of Gastroenterology and Hepatology, Istanbul, Turkey

dDepartment of Internal Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology, Scottsdale, Arizona, USA

Correspondence to Tan Attila, MD, Amerikan Hastanesi, Guzelbahce Sokak, No. 20, Nisantasi, Istanbul 34364, Turkey Tel: +90 533 354 30 90; fax: +90 212 311 23 45; e-mail: tanattila2003@yahoo.com

Received July 10, 2018

Accepted September 28, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.