Safety of endoscopic ultrasound-guided ethanol ablation for pancreatic cystic lesions: A single-center experience of 214 patients
Endoscopic ultrasound-guided ethanol ablation (EUS-EA) for pancreatic cystic lesions (PCLs) has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery. The present study aimed to confirm the safety of EUS-EA and to f...
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| Veröffentlicht in: | Hepatobiliary & pancreatic diseases international 2019-12, Vol.18 (6), p.562-568 |
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| creator | Choi, Jin Ho Lee, Sang Hyub Choi, Young Hoon You, Min Su Shin, Bang-Sup Paik, Woo Hyun Ryu, Ji Kon Kim, Yong-Tae |
| description | Endoscopic ultrasound-guided ethanol ablation (EUS-EA) for pancreatic cystic lesions (PCLs) has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery. The present study aimed to confirm the safety of EUS-EA and to find predictive factors for adverse event (AE).
A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital. The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA. The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain.
A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows: serous cystic neoplasm (32.2%), mucinous cystic neoplasm (26.6%), branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) (29.4%), and pseudocyst (11.7%). Three patients (1.4%) experienced severe AEs. Overall, AEs occurred in 71 (33.2%) patients. BD-IPMN (OR: 2.87; 95% CI: 1.05–7.84; P = 0.040), multilocular cysts (OR: 3.59; 95% CI: 1.09–11.85; P = 0.036), suspected ethanol leakage during procedure (OR: 10.68; 95% CI: 1.98–57.53; P = 0.006), and sticky cystic fluid (OR: 3.83; 95% CI: 1.20–12.24; P = 0.024) were predictive factors for post-procedural acute pancreatitis. PCLs of uncinate process (OR: 2.99; 95% CI: 1.22–7.35; P = 0.017) and PCLs with exophytic portion (OR: 3.70; 95% CI: 1.96–7.01; P |
| doi_str_mv | 10.1016/j.hbpd.2019.09.004 |
| format | Article |
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A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital. The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA. The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain.
A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows: serous cystic neoplasm (32.2%), mucinous cystic neoplasm (26.6%), branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) (29.4%), and pseudocyst (11.7%). Three patients (1.4%) experienced severe AEs. Overall, AEs occurred in 71 (33.2%) patients. BD-IPMN (OR: 2.87; 95% CI: 1.05–7.84; P = 0.040), multilocular cysts (OR: 3.59; 95% CI: 1.09–11.85; P = 0.036), suspected ethanol leakage during procedure (OR: 10.68; 95% CI: 1.98–57.53; P = 0.006), and sticky cystic fluid (OR: 3.83; 95% CI: 1.20–12.24; P = 0.024) were predictive factors for post-procedural acute pancreatitis. PCLs of uncinate process (OR: 2.99; 95% CI: 1.22–7.35; P = 0.017) and PCLs with exophytic portion (OR: 3.70; 95% CI: 1.96–7.01; P < 0.001) were predictive factors for post-procedural abdominal pain.
EUS-EA is a safe procedure with a very low rate of severe AEs. It seems possible to predict the AEs according to the features of the procedure and PCLs.</description><identifier>ISSN: 1499-3872</identifier><identifier>DOI: 10.1016/j.hbpd.2019.09.004</identifier><identifier>PMID: 31551143</identifier><language>eng</language><publisher>Singapore: Elsevier B.V</publisher><subject>Abdominal Pain - etiology ; Ablation Techniques - adverse effects ; Adult ; Adverse events ; Aged ; Databases, Factual ; Ethanol - administration & dosage ; Ethanol - adverse effects ; EUS-guided ethanol ablation ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous - diagnostic imaging ; Neoplasms, Cystic, Mucinous, and Serous - surgery ; Pain, Postoperative - etiology ; Pancreatic cyst ; Pancreatic Cyst - diagnostic imaging ; Pancreatic Cyst - surgery ; Pancreatic Intraductal Neoplasms - diagnostic imaging ; Pancreatic Intraductal Neoplasms - surgery ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatic Neoplasms - surgery ; Pancreatic Pseudocyst - diagnostic imaging ; Pancreatic Pseudocyst - surgery ; Pancreatitis - etiology ; Patient Safety ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Seoul ; Treatment Outcome ; Ultrasonography, Interventional</subject><ispartof>Hepatobiliary & pancreatic diseases international, 2019-12, Vol.18 (6), p.562-568</ispartof><rights>2019</rights><rights>Copyright © 2019. Published by Elsevier B.V.</rights><rights>Copyright © Wanfang Data Co. Ltd. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c458t-34eb9cccf54d01d78c03c4136bbe6339ff0a785c3a02db0f7c31132cefa7a18f3</citedby><cites>FETCH-LOGICAL-c458t-34eb9cccf54d01d78c03c4136bbe6339ff0a785c3a02db0f7c31132cefa7a18f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://www.wanfangdata.com.cn/images/PeriodicalImages/gjgdybzz-z/gjgdybzz-z.jpg</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1499387219301821$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31551143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Jin Ho</creatorcontrib><creatorcontrib>Lee, Sang Hyub</creatorcontrib><creatorcontrib>Choi, Young Hoon</creatorcontrib><creatorcontrib>You, Min Su</creatorcontrib><creatorcontrib>Shin, Bang-Sup</creatorcontrib><creatorcontrib>Paik, Woo Hyun</creatorcontrib><creatorcontrib>Ryu, Ji Kon</creatorcontrib><creatorcontrib>Kim, Yong-Tae</creatorcontrib><title>Safety of endoscopic ultrasound-guided ethanol ablation for pancreatic cystic lesions: A single-center experience of 214 patients</title><title>Hepatobiliary & pancreatic diseases international</title><addtitle>Hepatobiliary Pancreat Dis Int</addtitle><description>Endoscopic ultrasound-guided ethanol ablation (EUS-EA) for pancreatic cystic lesions (PCLs) has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery. The present study aimed to confirm the safety of EUS-EA and to find predictive factors for adverse event (AE).
A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital. The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA. The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain.
A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows: serous cystic neoplasm (32.2%), mucinous cystic neoplasm (26.6%), branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) (29.4%), and pseudocyst (11.7%). Three patients (1.4%) experienced severe AEs. Overall, AEs occurred in 71 (33.2%) patients. BD-IPMN (OR: 2.87; 95% CI: 1.05–7.84; P = 0.040), multilocular cysts (OR: 3.59; 95% CI: 1.09–11.85; P = 0.036), suspected ethanol leakage during procedure (OR: 10.68; 95% CI: 1.98–57.53; P = 0.006), and sticky cystic fluid (OR: 3.83; 95% CI: 1.20–12.24; P = 0.024) were predictive factors for post-procedural acute pancreatitis. PCLs of uncinate process (OR: 2.99; 95% CI: 1.22–7.35; P = 0.017) and PCLs with exophytic portion (OR: 3.70; 95% CI: 1.96–7.01; P < 0.001) were predictive factors for post-procedural abdominal pain.
EUS-EA is a safe procedure with a very low rate of severe AEs. It seems possible to predict the AEs according to the features of the procedure and PCLs.</description><subject>Abdominal Pain - etiology</subject><subject>Ablation Techniques - adverse effects</subject><subject>Adult</subject><subject>Adverse events</subject><subject>Aged</subject><subject>Databases, Factual</subject><subject>Ethanol - administration & dosage</subject><subject>Ethanol - adverse effects</subject><subject>EUS-guided ethanol ablation</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms, Cystic, Mucinous, and Serous - diagnostic imaging</subject><subject>Neoplasms, Cystic, Mucinous, and Serous - surgery</subject><subject>Pain, Postoperative - etiology</subject><subject>Pancreatic cyst</subject><subject>Pancreatic Cyst - diagnostic imaging</subject><subject>Pancreatic Cyst - surgery</subject><subject>Pancreatic Intraductal Neoplasms - diagnostic imaging</subject><subject>Pancreatic Intraductal Neoplasms - surgery</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Pancreatic Pseudocyst - diagnostic imaging</subject><subject>Pancreatic Pseudocyst - surgery</subject><subject>Pancreatitis - etiology</subject><subject>Patient Safety</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Seoul</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional</subject><issn>1499-3872</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU2LFDEQzUFx19E_4EFyFKTHpNOf4mVZXBUWPKjnkK5UetP0JG2SVmdu_vNNO6tHoaAo6n3Ae4S84GzPGW_eTPu7YdH7kvF-z_Kw6hG55FXfF6JrywvyNMaJsbLr6uYJuRC8rjmvxCX5_UUZTEfqDUWnfQS_WKDrnIKKfnW6GFerUVNMd8r5maphVsl6R40PdFEOAuYbKBzjtmaM-Rnf0isarRtnLABdwkDx14LBogPcrEpeZXLKd4rPyGOj5ojPH_aOfLt5__X6Y3H7-cOn66vbAqq6S4WocOgBwNSVZly3HTABFRfNMGAjRG8MU21Xg1Cs1AMzLQjORQloVKt4Z8SOvD7r_lTOKDfKya_BZUc5TqM-DqeTPG3xsYZl4o68OqOX4L-vGJM82Ag4z8qhX6Msy77lZdPXIkPLMxSCjzGgkUuwBxWOkjO5lSMnuZUjN3XJ8rAqk14-6K_DAfU_yt9mMuDdGYA5kx8Wg4zwJz9tA0KS2tv_6d8D3PekwA</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Choi, Jin Ho</creator><creator>Lee, Sang Hyub</creator><creator>Choi, Young Hoon</creator><creator>You, Min Su</creator><creator>Shin, Bang-Sup</creator><creator>Paik, Woo Hyun</creator><creator>Ryu, Ji Kon</creator><creator>Kim, Yong-Tae</creator><general>Elsevier B.V</general><general>Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20191201</creationdate><title>Safety of endoscopic ultrasound-guided ethanol ablation for pancreatic cystic lesions: A single-center experience of 214 patients</title><author>Choi, Jin Ho ; Lee, Sang Hyub ; Choi, Young Hoon ; You, Min Su ; Shin, Bang-Sup ; Paik, Woo Hyun ; Ryu, Ji Kon ; Kim, Yong-Tae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c458t-34eb9cccf54d01d78c03c4136bbe6339ff0a785c3a02db0f7c31132cefa7a18f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Pain - etiology</topic><topic>Ablation Techniques - adverse effects</topic><topic>Adult</topic><topic>Adverse events</topic><topic>Aged</topic><topic>Databases, Factual</topic><topic>Ethanol - administration & dosage</topic><topic>Ethanol - adverse effects</topic><topic>EUS-guided ethanol ablation</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms, Cystic, Mucinous, and Serous - diagnostic imaging</topic><topic>Neoplasms, Cystic, Mucinous, and Serous - surgery</topic><topic>Pain, Postoperative - etiology</topic><topic>Pancreatic cyst</topic><topic>Pancreatic Cyst - diagnostic imaging</topic><topic>Pancreatic Cyst - surgery</topic><topic>Pancreatic Intraductal Neoplasms - diagnostic imaging</topic><topic>Pancreatic Intraductal Neoplasms - surgery</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Pancreatic Pseudocyst - diagnostic imaging</topic><topic>Pancreatic Pseudocyst - surgery</topic><topic>Pancreatitis - etiology</topic><topic>Patient Safety</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Seoul</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Jin Ho</creatorcontrib><creatorcontrib>Lee, Sang Hyub</creatorcontrib><creatorcontrib>Choi, Young Hoon</creatorcontrib><creatorcontrib>You, Min Su</creatorcontrib><creatorcontrib>Shin, Bang-Sup</creatorcontrib><creatorcontrib>Paik, Woo Hyun</creatorcontrib><creatorcontrib>Ryu, Ji Kon</creatorcontrib><creatorcontrib>Kim, Yong-Tae</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>Hepatobiliary & pancreatic diseases international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Jin Ho</au><au>Lee, Sang Hyub</au><au>Choi, Young Hoon</au><au>You, Min Su</au><au>Shin, Bang-Sup</au><au>Paik, Woo Hyun</au><au>Ryu, Ji Kon</au><au>Kim, Yong-Tae</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety of endoscopic ultrasound-guided ethanol ablation for pancreatic cystic lesions: A single-center experience of 214 patients</atitle><jtitle>Hepatobiliary & pancreatic diseases international</jtitle><addtitle>Hepatobiliary Pancreat Dis Int</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>18</volume><issue>6</issue><spage>562</spage><epage>568</epage><pages>562-568</pages><issn>1499-3872</issn><abstract>Endoscopic ultrasound-guided ethanol ablation (EUS-EA) for pancreatic cystic lesions (PCLs) has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery. The present study aimed to confirm the safety of EUS-EA and to find predictive factors for adverse event (AE).
A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital. The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA. The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain.
A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows: serous cystic neoplasm (32.2%), mucinous cystic neoplasm (26.6%), branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) (29.4%), and pseudocyst (11.7%). Three patients (1.4%) experienced severe AEs. Overall, AEs occurred in 71 (33.2%) patients. BD-IPMN (OR: 2.87; 95% CI: 1.05–7.84; P = 0.040), multilocular cysts (OR: 3.59; 95% CI: 1.09–11.85; P = 0.036), suspected ethanol leakage during procedure (OR: 10.68; 95% CI: 1.98–57.53; P = 0.006), and sticky cystic fluid (OR: 3.83; 95% CI: 1.20–12.24; P = 0.024) were predictive factors for post-procedural acute pancreatitis. PCLs of uncinate process (OR: 2.99; 95% CI: 1.22–7.35; P = 0.017) and PCLs with exophytic portion (OR: 3.70; 95% CI: 1.96–7.01; P < 0.001) were predictive factors for post-procedural abdominal pain.
EUS-EA is a safe procedure with a very low rate of severe AEs. It seems possible to predict the AEs according to the features of the procedure and PCLs.</abstract><cop>Singapore</cop><pub>Elsevier B.V</pub><pmid>31551143</pmid><doi>10.1016/j.hbpd.2019.09.004</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Hepatobiliary & pancreatic diseases international, 2019-12, Vol.18 (6), p.562-568 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Abdominal Pain - etiology Ablation Techniques - adverse effects Adult Adverse events Aged Databases, Factual Ethanol - administration & dosage Ethanol - adverse effects EUS-guided ethanol ablation Female Humans Male Middle Aged Neoplasms, Cystic, Mucinous, and Serous - diagnostic imaging Neoplasms, Cystic, Mucinous, and Serous - surgery Pain, Postoperative - etiology Pancreatic cyst Pancreatic Cyst - diagnostic imaging Pancreatic Cyst - surgery Pancreatic Intraductal Neoplasms - diagnostic imaging Pancreatic Intraductal Neoplasms - surgery Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - surgery Pancreatic Pseudocyst - diagnostic imaging Pancreatic Pseudocyst - surgery Pancreatitis - etiology Patient Safety Retrospective Studies Risk Assessment Risk Factors Seoul Treatment Outcome Ultrasonography, Interventional |
| title | Safety of endoscopic ultrasound-guided ethanol ablation for pancreatic cystic lesions: A single-center experience of 214 patients |
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