Endoscopic Ultrasound-guided Ethanol Injection of Pancreatic Cystic Neoplasms

• Status: Completed
• Trial end date: 2015-09-01
• Target enrollment: 0
• Participant gender: All

Summary

Cystic tumors of the pancreas are fluid-filled growths. They are often treated by surgical removal. A safe and effective non-surgical treatment is desirable. Ethanol (alcohol) injection may treat cysts by killing the lining cells of the cyst, and is an accepted treatment for cysts of other organs. In this study, participants with pancreatic cysts underwent endoscopic ultrasound (EUS) guided ethanol injection of pancreatic cysts. This was a pilot study to assess safety and efficacy.

The hypotheses of this study were 1) complications of EUS guided ethanol injection requiring hospitalization will occur in <10% of subjects, and 2) EUS guided ethanol injection, with retreatment as necessary, will ablate at least 50% of pancreatic cysts.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Mayo Clinic
• Treatments: Ethanol; Lidocaine

Criteria

Inclusion Criteria:

1. Presence of a pancreatic cystic lesion, > 1 cm in maximum diameter

2. Treatment of the cystic lesion is desired due to symptoms or concern for subsequent malignancy

3. Age > or = 18 years

4. Able to give informed consent

5. Surgical treatment has been considered, and a surgical consultation offered to the patient, but:

1. Subject's cyst does not meet consensus criteria for surgical resection, or

2. Subject is deemed a poor operative candidate, or

3. Ethanol ablation would allow a subtotal rather than total pancreatectomy, or

4. Subject has decided not to undergo surgical treatment.

Exclusion Criteria:

1. Known or suspected pregnancy, or nursing

2. History of pancreatitis within past 3 months

3. Main pancreatic duct is dilated to > 4mm in neck, body, or tail

4. Cyst is known to communicate with the pancreatic duct

5. Cyst has a primarily microcystic architecture on EUS

6. Cyst is immediately adjacent to the main pancreatic duct on EUS

7. Cyst has a connection to the main pancreatic duct seen during EUS

8. During initial cyst aspiration, more fluid is recovered than expected (suggesting communication to the main pancreatic duct)

9. Pancreatic cytology has demonstrated cancer