Korean J Gastroenterol.  2018 Jan;71(1):10-17. 10.4166/kjg.2018.71.1.10.

Endoscopic Treatment for Pancreatic Cystic Lesions

Affiliations
  • 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. gidoctor@snuh.org
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract

The decision of the appropriate treatment for pancreatic cystic lesions (PCLs) is becoming increasingly important as the number of incidentally found PCLs increases. A range of modalities have been attempted because there has been an increasing demand for minimally invasive treatment for PCLs due to the large burden of a surgical resection. Endoscopic treatment using endoscopic ultrasonography (EUS), a representative of minimally invasive therapy, can be categorized into two types: ablation therapy by the injection of drugs and topical thermal coagulative therapy through the high topical energy. A number of studies reported the feasibility and efficacy of these treatments; the most common is EUS-guided ablation for PCLS with ethanol alone or in combination with anticancer drugs. Although ablation therapies with drug injection have proven safety and feasibility, there is no consensus regarding the actual treatment effects and indications of these modalities. EUS-guided radiofrequency ablation was recently attempted as a representative method of local thermal coagulation, but further studies will be needed because of the lack of evidence of its feasibility and safety. In addition, a range of treatments for malignant tumors rather than PCLs have been attempted, such as EUS-guided photodynamic therapy, EUS-guided neodymium-doped yttrium aluminum garnet laser, and high-intensity focused ultrasound, based on the data from animal experiments. Through further study, endoscopic treatment is expected to become established as a useful treatment modality for PCLs.

Keyword

Pancreatic cyst; Endosonography; Therapy

MeSH Terms

Aluminum
Animal Experimentation
Catheter Ablation
Consensus
Endosonography
Ethanol
Methods
Pancreatic Cyst*
Photochemotherapy
Ultrasonography
Yttrium
Aluminum
Ethanol
Yttrium

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Jung Won Chun, Sang Hyub Lee, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
Clin Endosc. 2019;52(5):510-515.    doi: 10.5946/ce.2018.191.

Future Perspectives on Endoscopic Ultrasonography-Guided Therapy for Pancreatic Neoplasm
Woo Hyun Paik, Sang Hyub Lee, Sunguk Jang
Clin Endosc. 2018;51(3):229-234.    doi: 10.5946/ce.2018.063.


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