https://scholars.lib.ntu.edu.tw/handle/123456789/540962
標題: | Safety and efficacy of EUS-guided ethanol ablation for treating small solid pancreatic Neoplasm | 作者: | Paik W.H. Seo D.W. Dhir V. HSIU-PO WANG |
公開日期: | 2016 | 出版社: | Lippincott Williams and Wilkins | 卷: | 95 | 期: | 4 | 來源出版物: | Medicine (United States) | 摘要: | The strategy for treating small borderline malignant pancreatic neoplasms-such as neuroendocrine tumor (NET) and solid pseudopapillary neoplasm (SPN)-is surgical resection. However, pancreatic resection of these lesions still causes significant morbidity. We evaluated the safety and efficacy of EUS-guided ethanol ablation to treat small solid pancreatic neoplasms. A total of 8 patients with small borderline malignant pancreatic neoplasms and co-morbidities who refused surgery were included. We identified 2 cases of nonfunctioning NET, 3 cases of insulinomas, 1 case of gastrinoma, and 2 cases of SPN. EUS-guided ethanol ablation was performed, and treatment outcomes were assessed with clinical symptom, hormone assay, and imaging study. The mean tumor diameter was 15mm (range, 7-29 mm), and the median volume of injected ethanol was 2.8mL (range, 1.2-10.5 mL). There was 1 severe acute pancreatitis after EUS-guided ethanol ablation with 20-gauge CPN needle. During follow-up (median 16.5 months), 6 patients achieved treatment success; however, 2 patients (1 nonfunctioning NET and 1 SPN) still had persistent tumors. The patient with persistent SPN underwent surgical resection and the histopathological results showed peripancreatic infiltration with perineural invasion. Among 6 patients who achieved initial treatment success, 1 patient experienced tumor recurrence within 15 months and underwent repeated EUS-guided ethanol ablation. In conclusion, EUS-guided ethanol ablation therapy is a promising option for patients with small solid pancreatic neoplasm. Multiple sessions or surgical interventions may be required if there is a recurrent or persistent mass, and procedure-related adverse events must be carefully monitored. Copyright ? 2016 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84957900931&doi=10.1097%2fMD.0000000000002538&partnerID=40&md5=17ebc3437d4399603d8142eea728e401 https://scholars.lib.ntu.edu.tw/handle/123456789/540962 |
ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000002538 | SDG/關鍵字: | alcohol; sonovue; alcohol; topical antiinfective agent; abdominal pain; acute pancreatitis; adult; aged; Article; cancer therapy; clinical article; clinical effectiveness; comorbidity; endoplasmic ultrasound guided ethanol ablation; female; fever; follow up; gastrinoma; histopathology; hormone determination; human; human tissue; hypoglycemia; insulinoma; male; middle aged; needle; nuclear magnetic resonance imaging; pancreas tumor; pancreatic neuroendocrine tumor; paraplegia; perineural invasion; priority journal; safety; solid pseudopapillary tumor; solid tumor; symptom; treatment outcome; tumor recurrence; tumor volume; ultrasound scanner; young adult; ablation therapy; adverse effects; endoscopic ultrasonography; gastrinoma; insulinoma; interventional ultrasonography; intralesional drug administration; Neuroendocrine Tumors; Pancreatic Neoplasms; pathology; reoperation; very elderly; Ablation Techniques; Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Endosonography; Ethanol; Female; Gastrinoma; Humans; Injections, Intralesional; Insulinoma; Male; Middle Aged; Neoplasm Recurrence, Local; Neuroendocrine Tumors; Pancreatic Neoplasms; Reoperation; Tumor Burden; Ultrasonography, Interventional; Young Adult |
顯示於: | 醫學系 |
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