摘要
Background:Endoscopic ultrasound-guided ethanol ablation(EUS-EA)for pancreatic cystic lesions(PCLs)has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery.The present study aimed to confirm the safety of EUS-EA and to find predictive factors for adverse event(AE).Methods:A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital.The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA.The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain.Results:A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows:serous cystic neoplasm(32.2%),mucinous cystic neoplasm(26.6%),branch duct type intraductal papillary mucinous neoplasm(BD-IPMN)(29.4%),and pseudocyst(11.7%).Three patients(1.4%)experienced severe AEs.Overall,AEs occurred in 71(33.2%)patients.BD-IPMN(OR:2.87;95%CI:1.05–7.84;P=0.040),multilocular cysts(OR:3.59;95%CI:1.09–11.85;P=0.036),suspected ethanol leakage during procedure(OR:10.68;95%CI:1.98–57.53;P=0.006),and sticky cystic fluid(OR:3.83;95%CI:1.20–12.24;P=0.024)were predictive factors for post-procedural acute pancreatitis.PCLs of uncinate process(OR:2.99;95%CI:1.22–7.35;P=0.017)and PCLs with exophytic portion(OR:3.70;95%CI:1.96–7.01;P<0.001)were predictive factors for post-procedural abdominal pain.Conclusions:EUS-EA is a safe procedure with a very low rate of severe AEs.It seems possible to predict the AEs according to the features of the procedure and PCLs.
Background: Endoscopic ultrasound-guided ethanol ablation(EUS-EA) for pancreatic cystic lesions(PCLs) has been used in recent years as a feasible treatment modality for low malignant probability PCLs or patients considered high-risk for surgery. The present study aimed to confirm the safety of EUS-EA and to find predictive factors for adverse event(AE). Methods: A retrospective review was performed from the prospectively maintained database of patients who underwent EUS-EA for PCLs from June 2006 to April 2018 at Seoul National University Hospital. The primary outcomes of the study were the rates of AEs and severe AEs by EUS-EA. The secondary outcome was the predictive factors of AEs including acute pancreatitis and abdominal pain. Results: A total of 214 patients were evaluated and the diagnoses of PCLs according to cystic fluid analysis and clinical features were as follows: serous cystic neoplasm(32.2%), mucinous cystic neoplasm(26.6%), branch duct type intraductal papillary mucinous neoplasm(BD-IPMN)(29.4%), and pseudocyst(11.7%). Three patients(1.4%) experienced severe AEs. Overall, AEs occurred in 71(33.2%) patients. BD-IPMN(OR: 2.87; 95% CI: 1.05–7.84; P = 0.040), multilocular cysts(OR: 3.59; 95% CI: 1.09–11.85; P = 0.036), suspected ethanol leakage during procedure(OR: 10.68; 95% CI: 1.98–57.53; P = 0.006), and sticky cystic fluid(OR: 3.83; 95% CI: 1.20–12.24; P = 0.024) were predictive factors for post-procedural acute pancreatitis. PCLs of uncinate process(OR: 2.99; 95% CI: 1.22–7.35; P = 0.017) and PCLs with exophytic portion(OR: 3.70; 95% CI: 1.96–7.01; P < 0.001) were predictive factors for post-procedural abdominal pain. Conclusions: EUS-EA is a safe procedure with a very low rate of severe AEs. It seems possible to predict the AEs according to the features of the procedure and PCLs.
