23 - Endoscopic Ultrasonography-Guided Radiofrequency Ablation Combined With Lauromacrogol Ablation for Pancreatic Cystic Neoplasms
Tuesday, October 9
9:10 AM - 9:20 AM
Location: Terrace Ballroom 4 (level 400)
Category: Interventional Endoscopy
Enqiang Linghu, MD, PhD, Xiuxue Feng, MD, Ningli Chai, MD, PhD, Huikai Li, MD
Chinese PLA General Hospital, Beijing, China (People's Republic)
Award: ACG Governors Award for Excellence in Clinical Research
Enqiang Linghu, MD, PhD
Department of Gastroenterology & Hepatology
Chinese PLA General Hospital
Beijing, Beijing, China (People's Republic)
Introduction: The prevalence and clinical variability of pancreatic cystic neoplasms (PCNs) have presented a significant treatment challenge. Endoscopic ultrasonography (EUS)-guided ablation provides one minimally invasive treatment, but the resolution still needs to be improved. The aim of this study is to investigate the safety and response of EUS-guide radiofrequency ablation (RFA) combined with lauromacrogol ablation (LA).
Methods: In a prospective single-center study, 21 patients were enrolled to undergo EUS-guide RFA combined with LA from August 2016 to May 2018. The treatment response was analyzed by measuring cyst volume before and more than 3 months after treatment, and classified as complete response (CR), partial response (PR), or persistent, with 25% of the original volume respectively.
Results: The 21 patients included 4 males and 17 females with mean age 44 years (range 24-74 years). Of the 21 cysts (mean diameter 3.67 cm and median volume 14.65 ml), 8 located in pancreatic head/uncinate, 6 in pancreatic body, 7 in pancreatic tail. Clinical diagnoses were mucinous cystic neoplasm in 5 patients, serous cystadenoma in 16 patients. EUS-guided RFA combined with LA was successfully performed in all cases. Mild acute pancreatitis occurred in one patient, hyperamylasemia in one patient and mild abdominal pain in two patients. 4 patients underwent treatment less than 3 months. For the remaining 17 patients, surveillance imaging was performed in median 4 months with median volume from 17.27 ml to 0.99 ml, and presented CR in 8 patients (47%), PR in 6 patients (35%), and persistent cysts in 3 patients (18%).
Discussion: EUS-guided RFA combined with LA appears to be a safe, feasible and effective method for treating PCNs. However, the efficacy and optimum indications are still need to investigate from a large and long-term follow-up study and in different PCNs.
MCN case: A, B, C show one cystic lesion in the pancreatic body, and size in MRI is 3.2x2.3x2.6cm; D the cyst disappears four months later after combination treatment.
SCN case: A, B, C show one cystic lesion in the pancreatic neck, and size in MRI is 5.7x5.2x4.5cm; D four months after combination treatment, the cyst size in MRI is 1.6x1.1x1.5cm.
Enqiang Linghu indicated no relevant financial relationships.
Xiuxue Feng indicated no relevant financial relationships.
Ningli Chai indicated no relevant financial relationships.
Huikai Li indicated no relevant financial relationships.