Ann Hepatobiliary Pancreat Surg.  2021 Aug;25(3):342-348. 10.14701/ahbps.2021.25.3.342.

Surgical outcomes are hampered after endoscopic ultrasonography-guided ethanol lavage and/or Taxol injection in cystic lesions of the pancreas

• Kim SR
• Kim SC
• Song KB
• Park KM
• Hwang DW
• Lee JH
• Shin SH
• Kwak BJ
• Lee YJ

• KMID: 2519290
• DOI: http://doi.org/10.14701/ahbps.2021.25.3.342

Abstract

Backgrounds/Aims
Endoscopic ultrasonography-guided ethanol lavage and Taxol injection (EUS-ELTI) for pancreatic cystic lesions have been recently performed in some medical centers. The aim of this study was to optimize patient selection and analyze outcomes of patients who underwent surgeries after EUS-ELTI for pancreatic cystic lesions.
Methods
Among 310 patients who underwent EUS-ELTI between January 2007 and December 2014, 23 underwent surgeries after EUS-ELTI owing to incomplete treatment and/or adverse events. Surgical outcomes of patients who underwent surgeries after EUSELTI were evaluated. Clinical outcomes of patients who underwent surgeries after EUS-ELTI were then retrospectively compared with those of patients who underwent upfront surgery for left-sided pancreatic lesions without an EUS-ELTI procedure.
Results
The pathology revealed degenerated cysts in 12 patients, mucinous cyst neoplasms in five, neuroendocrine tumors in two, intraductal papillary mucinous neoplasm (IPMN) in one, solid pseudopapillary tumor in one, pancreatic ductal adenocarcinoma arising from an IPMN in one, and hepatoid carcinoma in one. Twelve patients underwent laparoscopic distal pancreatectomy and five patients underwent open distal pancreatectomy. When clinical outcomes were retrospectively compared between patients who underwent laparoscopic distal pancreatectomy after EUS-ELTI and those who did not receive an EUS-ELTI procedure, the spleen-preserving rate was 0% in the EUS-ELTI group and 61.7% (365/592) in the control group (p < 0.001).
Conclusions
Surgical outcomes are compromised after EUS-ELTI for cystic tumor of the pancreas. Further studies are needed to investigate the efficacy and safety of the EUS-ELTI procedure.

Keyword

Endoscopic ultrasonography-guided ethanol lavage and Taxol injection; Minimally invasive surgery; Pancreatic cystic neoplasm

Figure

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  Fig. 1 Study flow diagram. EUS-ELTI, Endoscopic ultrasonography-guided ethanol lavage and Taxol injection; AMC, Asan Medical Center.

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  Fig. 2 Distribution of tumor location.

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