Endoscopic Ultrasound (EUS)-Guided Ablation of Pancreatic Cysts

Study Overview
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Brief Summary
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The purpose of this study is to track outcomes and complications of patients at IUMC referred by physicians for EUS-guided pancreatic cyst ablation. This information is essential in order to disseminate future published information to physicians about this technique. A database will be created to track these patients undergoing an already scheduled/planned procedure. Phone calls at selected intervals will be made following the procedure to track any complications that occur

Detailed Description
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Pancreatic cysts represent a wide spectrum of lesions. Many cysts are uniformly benign (pseudocysts) or have negligible malignant potential (serous cystadenomas). However, others represent premalignant (i.e. intraductal papillary mucinous neoplasms (IPMNs) or mucinous cystadenomas [MCN]), or malignant (i.e. invasive IPMNs or mucinous cystadenocarcinomas) tumors. Management of pancreatic cysts is challenging but surgery is generally recommended for cysts that are symptomatic, premalignant (except possibly branch duct IPMNs) or demonstrate malignancy by imaging features and/or biopsy. However, even in experienced hospitals, surgical resection or enucleation of pancreatic cystic tumors is associated with significant perioperative morbidity and mortality rates of 20-40% and up to 2%, respectively.

Official Title
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Endoscopic Ultrasound (EUS)-Guided Ablation of Pancreatic Cysts

Conditions
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Pancreatic Cyst, Pancreatic Intraductal Papillary-Mucinous Neoplasm, Cystadenoma, Mucinous, Papillary Mucinous Cystadenoma, Borderline Malignancy

Intervention / Treatment
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* Procedure: 98% Ethanol & Paclitaxel injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients referred between January 2009 and February 2016 to EUS at IUMC for pancreatic cyst ablation and with no contraindications for anticipated safe and successful performance of the procedure. Patient at least 18 years of age. Exclusion Criteria: Investigator deems cyst does not meet safety or need for cyst ablation. Subject not competent to sign consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 98% Ethanol with Paclitaxel injection<br> | Procedure: 98% Ethanol & Paclitaxel injection<br>* Pancreatic cyst injection via Endoscopic Ultrasound (EUS)of 98% Ethanol with Paclitaxel (dose determined in relation to cyst size & amount of fluid aspirated from the cyst.<br>* Other names: Pancreatic cyst injection of Paclitaxel.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cyst resolution | 1. Patients will undergo EUS-guided cyst ablation with ethanol +/- paclitaxel as indicated for their scheduled procedure. 2. Patients will return 3 months after initial ablation for a repeat EUS, and ablation will be repeated if cyst size is >10mm in diameter. 3. CT or MRI imaging will be performed 3 months after the second procedure to assess for cyst resolution. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intraductal papillary mucinous neoplasms (IPMNs), Mucinous cystadenomas [MCN]), Invasive IPMNs or mucinous cystadenocarcinomas) tumors