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Review
. 2023 Jan 17;13(3):344.
doi: 10.3390/diagnostics13030344.

A Review of Endoscopic Ultrasound-Guided Chemoablative Techniques for Pancreatic Cystic Lesions

Bryn Koehler  1 , Da Yeon Ryoo  1 , Somashekar G Krishna  2
Affiliations
Review

A Review of Endoscopic Ultrasound-Guided Chemoablative Techniques for Pancreatic Cystic Lesions

Bryn Koehler et al. Diagnostics (Basel). .

Abstract

Pancreatic cystic lesions (PCLs) are known precursors to pancreatic cancer, one of the deadliest types of cancer worldwide. Surgical removal or pancreatectomies remain the central approach to managing precancerous high-risk PCLs. Endoscopic ultrasound (EUS)-guided therapeutic management of PCLs is a novel management strategy for patients with prohibitive surgical risks. Various ablation techniques have been explored in previous studies utilizing EUS-guided fine needle injection (FNI) of alcohol and chemotherapeutic agents. This review article focuses on EUS-FNI and chemoablation, encompassing the evolution of chemoablation, pancreatic cyst selection, chemotherapy drug selection, including novel agents, and a discussion of its safety and efficacy.

Keywords: EUS-FNI; EUS-guided chemoablation; EUS-nCLE; LSAM-PTX; intraductal papillary mucinous neoplasms; mucinous cystic neoplasms; pancreatic cancer; pancreatic cystic lesions.

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Conflict of interest statement

Krishna SG is PI of an investigator-initiated study. The study in part is funded by a grant to The Ohio State University Wexner Medical Center from Mauna Kea Technologies, Paris, France.

Figures

Figure 1
Figure 1
EUS-guided chemoablation with large surface area microparticle paclitaxel (LSAM-PTX) of a branch-duct IPMN. CT-Scan of the abdomen showing a decrease in the lesion size comparing (A) pre-ablation to (B) post-ablation after 2 injections of LSAM-PTX by EUS-FNI.
See this image and copyright information in PMC

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