Pancreatic cysts are common and often incidentally detected on abdominal imaging.
Their prevalence in asymptomatic individuals depends on the screening modality used.
The incidence of these lesions increases with age and may be detected in nearly half
of elderly patients undergoing high-resolution magnetic resonance imaging. Some, but
not all, pancreas cysts have malignant potential. The overall risk is small but induces
significant anxiety for the patient. When determining management options, it is important
to consider the patient’s age, medical comorbidities, and surgical risks as well as
the wishes of the patient. Current strategies include imaging surveillance or surgical
resection. Before embarking on cyst surveillance, a clinician must factor in patients’
risk of developing malignancy, their life expectancy, medical comorbidities, and if
they are a surgical candidate. Surgery poses significant adverse events and mortality,
whereas radiographic surveillance imposes healthcare costs and psychological distress
to patients with the looming possibility of malignancy. The development and use of
endoscopic ultrasound cyst ablation is a minimally invasive alternative in treating
pancreatic cystic lesions. This review focuses on the modalities of ethanol ablation,
paclitaxel ablation, and radiofrequency ablation of pancreatic cystic lesions.
Abbreviations:
IPMN (intraductal papillary mucinous neoplasm), MCNs (mucinous cystic neoplasms), PCL (pancreatic cystic lesion), PNET (pancreatic neuroendocrine tumor), RFA (radiofrequency ablation), SCA (serous cystadenoma)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 05, 2019
Accepted:
September 29,
2019
Received:
July 17,
2019
Footnotes
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: T. Baron: Consultant and speaker for Boston Scientific, W. L. Gore, Cook Endoscopy, and Olympus America. R. Law: Consultant for Olympus America. All other authors disclosed no financial relationships.
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© 2020 by the American Society for Gastrointestinal Endoscopy
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- Endoscopic ablation of pancreatic cysts: not yet ready for general applicationGastrointestinal EndoscopyVol. 92Issue 5
- PreviewI would like to thank Dr Canakis and colleagues1 for the comprehensive updated review on ablative treatment of pancreatic cyst lesions (PCLs) recently published in Gastrointestinal Endoscopy. The options, unanswered questions, and limitations of the previous pioneering studies were well summarized in the conclusions.
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