Endoscopic Ultrasound (EUS) - Guided Chemoablation of Pancreatic Cysts | February 2024-EUS-Guided Chemoablation for Pancreatic Cysts

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EUS-guided chemoablation is a minimally invasive treatment option for managing mucinous pancreatic cysts. This procedure involves using a needle to aspirate the cyst and then infusing a chemotherapy admixture into the cyst to induce ablation. The goal of this treatment is to interrupt the progression of mucinous cysts to pancreatic cancer. EUS-guided chemoablation has shown promising results in terms of efficacy and long-term durability. Studies have demonstrated high complete ablation rates and low adverse event rates with this procedure. The procedure is typically performed at high-volume referral centers by interventional endoscopists with expertise in EUS. Patients who are good surgical candidates may also be considered for surgical resection, but for those at higher risk for surgical complications or who prefer a minimally invasive approach, EUS-guided chemoablation offers an attractive alternative. The procedure is not appropriate for all pancreatic cysts, and careful patient selection is crucial. Surveillance imaging with CT, MRI, or EUS is still recommended for most low-risk cysts, while surgical resection is still considered the gold standard for malignant or high-risk lesions. Future research is needed to further refine patient selection criteria, establish optimal follow-up intervals, and determine long-term outcomes. Overall, EUS-guided chemoablation provides a safe and effective alternative for managing mucinous pancreatic cysts, and it has the potential to reduce the need for major surgery in appropriately selected patients.

Keywords

EUS-guided chemoablation

minimally invasive treatment

mucinous pancreatic cysts

chemotherapy admixture

ablation induction

progression interruption

efficacy

long-term durability

complete ablation rates

adverse event rates