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Caillol F.,Paoli Calmette Institute Marseille | Poincloux L.,Paoli Calmette Institute Marseille | Bories E.,Paoli Calmette Institute Marseille | Cruzille E.,Paoli Calmette Institute Marseille | And 7 more authors.
Endoscopic Ultrasound | Year: 2012

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. Patients and 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. Conclusion: 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.


PubMed | Paoli Calmette Institute Marseille
Type: Journal Article | Journal: Endoscopic ultrasound | Year: 2014

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.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.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.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.

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