A prospective study on the safety and effectiveness of using lauromacrogol for ablation of pancreatic cystic neoplasms with the aid of EUS

• DOI: 10.1016/j.gie.2017.03.1525
• Publication Date: 2017-03-30T01:15:54Z
• Authors: Enqiang Linghu; Chen Du; Ningli Chai; Huikai Li; Zhiqiang Wang; Yufa Sun; Wei Xu; Xu Guo; Bo Ning; Lihua Sun; Wei Zhang; Xiangdong Wang; Ping Tang; Jia Feng
• Keywords: Ablation Techniques; Adult; Male; Polidocanol; Middle Aged; Sclerosing Solutions; Endosonography; Polyethylene Glycols; Tumor Burden; 3. Good health; Pancreatic Neoplasms; 03 medical and health sciences; 0302 clinical medicine; Pancreatitis; Retreatment; Humans; Female; Prospective Studies; Pancreatic Cyst; Aged

With the development of imaging techniques, the detection rate of pancreatic cystic neoplasms (PCNs) has increased. The surgical morbidity and mortality rates of PCNs are quite high. This study is intended to evaluate the safety and effectiveness of a minimally invasive treatment, EUS-guided PCN ablation with lauromacrogol.From April 2015 to May 2016, 120 patients with PCNs were enrolled to undergo EUS. We prospectively studied 29 of the 120 patients who underwent EUS-guided ablation with lauromacrogol. The follow-up contrast-enhanced CT or magnetic resonance image was conducted at 3 months and then 6 months after ablation. We determined the effectiveness of ablation by the changes in the volume of the cysts.Twenty-nine patients were enrolled in the study, and 7 of them underwent a second ablation; therefore, there were 36 treatments. The mean tumor diameter was 28.6 ± 14.5 mm preoperation, whereas the diameter postoperation was 13.4 ± 10.5 mm. Mild pancreatitis occurred in 2 patients and moderate fever in 1; they occurred in the cysts located in the head/uncinate. Among the 29 treatments with complete follow-up of 9 months (range, 3-15), 11 had complete response and 9 had partial response. The resolution rate was 37.9% (11/29) with 36.4% (8/22) in the cysts of the head/uncinate and 42.9% (3/7) in the body/tail (P > .05).EUS-guided PCN ablation with lauromacrogol is safe and efficient. Adverse event rates seem to be higher in the head/uncinate than in the body/tail, but their resolution rates are similar. Further studies involving larger populations and longer follow-ups are warranted.