Endoscopy 2018; 50(04): S37
DOI: 10.1055/s-0038-1637137
ESGE Days 2018 oral presentations
20.04.2018 – EUS: pancreas therapeutic
Georg Thieme Verlag KG Stuttgart · New York

CLINICAL OUTCOMES OF EUS-GUIDED ETHANOL ABLATION IS BETTER THAN THOSE OF THE NATURAL COURSE OF PANCREATIC CYSTS

JK Ryu
1   Seoul National University, Internal Medicine, Seoul, Korea, Republic of
,
KN Shim
2   Ewha Womans University College of Medicine, Internal Medicine, Seoul, Korea, Republic of
,
YT Kim
1   Seoul National University, Internal Medicine, Seoul, Korea, Republic of
,
YB Yoon
1   Seoul National University, Internal Medicine, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Endoscopic ultrasonography-guided ethanol ablation therapy for pancreatic cystic tumors is a minimally invasive treatment but still is an experimental therapy. The aim of this study was to compare the clinical outcomes of EUS-guided ethanol ablation with those of the natural course (NC) of pancreatic cysts.

Methods:

We performed retrospective study of patients with pancreatic cyst s divided in two groups: EUS-guided ethanol ablation group (n = 118) and NC group (n = 433). The propensity score-matching analysis between the two groups was applied in order to minimize the effect of selection bias. The primary outcome was the rate of significant reduction in size (< 20% of initial size). The secondary outcomes were the rate of significant growth in size (> 10 mm), complete remission rate, and surgical resection rate.

Results:

In a propensity-matched analysis of 84 pairs, there were no significant differences of baseline characteristics between two groups. The median initial cystic size of EUS-guided ethanol ablation group and NC group was 23.13 ± 10.99, 22.97 ± 12.15 mm respectively and the median follow-up duration was 78.8 months, 75.9 months respectively. Significant reduction in size was detected in 57 (67.9%) of the EUS-guided ethanol ablation group and 13 (15.5%) of the natural course group (p < 0.001). Significant growth in size was detected in 5 cysts (5.9%), 8 cysts (10.7%) respectively (p = 0.264). Twenty seven (32.2%) patients who underwent EUS-guided ethanol ablation had achieved the complete remission. Four patients underwent surgical resection in the EUS-guided ethanol ablation group (4.8%, all mucinous cysts) and 22 patients in the NC group (26.2%, 17 mucinous cysts, 5 non mucinous benign cysts) (p < 0.001) during follow-up.

Conclusions:

EUS-guided ethanol ablation revealed an excellent effect in reducing the size of pancreatic cysts and is also expected to achieve a complete remission and reduce the rate of surgical resection than NC group.