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Success of endoscopic ultrasound-guided ethanol ablation of pancreatic cysts: A meta-analysis and systematic review

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Abstract

Background

Endoscopic ultrasound (EUS)-guided ethanol ablation has emerged as an efficacious and safe alternative management option for pancreatic cysts. We undertook a meta-analysis and systematic review to assess the overall safety and efficacy of EUS-guided ethanol ablation of pancreatic cysts.

Method study selection criteria

EUS-guided ethanol ablation of pancreatic cysts.

Data collection extraction

Articles were searched in Medline, Pubmed, and Ovid journals.

Statistical method

Fixed and random effects models were used to calculate the pooled proportions.

Results

Initial search identified 1,319 reference articles, in which 120 relevant articles were selected and reviewed. Data was extracted from seven studies (n = 152) of EUS-guided ethanol ablation of pancreatic cysts, which met the inclusion criteria. With EUS-guided ethanol ablation, the pooled proportion of patients with complete cyst resolution was 56.20 % (95 % CI = 48.16 to 64.08) and partial cyst resolution was 23.72 % (95 % CI = 17.24 to 30.89). Postprocedural complications after ablation were significant for abdominal pain in 6.51 % (95 % CI = 3.12 to 11.04) and pancreatitis in 3.90 % (95 % CI = 1.39 to 7.60) of the pooled percentage of patients. Publication bias calculated using Harbord-Egger bias indicator gave a value of -1.09 (95 % CI = 10.21 to 8.03, p = 0.77). The Begg-Mazumdar indicator gave a Kendall’s tau b value of 0.05 (p ≥ 0.99).

Conclusions

EUS-guided ethanol ablation may be a safe alternative treatment modality for pancreatic cysts, with acceptable intraprocedural and postprocedural complications. However, due to the limited data available, prospective randomized controlled trials with a long follow up period are required in this area.

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Conflict of interest

MK, HM, MC, FHV, MLB, and SRP declare that they have no competing interests.

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Authors and Affiliations

  1. Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA

    Manasa Kandula & Harsha Moole

  2. Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA

    Michael Cashman, Fritz H. Volmar & Srinivas R. Puli

  3. Division of Gastroenterology and Hepatology, University of Missouri at Columbia, Columbia, MO, USA

    Matthew L. Bechtold

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  1. Manasa Kandula
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  2. Harsha Moole
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  3. Michael Cashman
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Correspondence to Manasa Kandula.

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Kandula, M., Moole, H., Cashman, M. et al. Success of endoscopic ultrasound-guided ethanol ablation of pancreatic cysts: A meta-analysis and systematic review. Indian J Gastroenterol 34, 193–199 (2015). https://doi.org/10.1007/s12664-015-0575-2

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  • DOI: https://doi.org/10.1007/s12664-015-0575-2

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