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Endoscopic Ultrasound-guided Ethanol Injection of Pancreatic Cystic Neoplasms


2004-06


2015-09


2015-09


33

Study Overview

Endoscopic Ultrasound-guided Ethanol Injection of Pancreatic Cystic Neoplasms

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.

EUS is performed via the mouth under sedation. After a needle is placed into the pancreas cyst under EUS guidance, an ethanol solution is placed into the cyst via the needle. The ethanol solution is withdrawn and new ethanol injected, and this process is continued for 5 minutes, repeatedly washing the cyst with the ethanol solution. After this treatment, usual clinical follow-up is obtained including assessments of the cyst by CT or MRI scans. If a cyst of significant size persists, additional EUS-guided ethanol injections of the cyst were offered.

  • Neoplasms, Cystic, Mucinous, and Serous
  • DRUG: Ethanol
  • DRUG: Lidocaine
  • 498-04

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2013-09-30  

2015-12-22  

2017-07-27  

2014-06-04  

2015-12-22  

2018-02-05  

2014-06-06  

2016-01-29  

2017-07  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment


Allocation:
Na


Interventional Model:
Single Group


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: Pancreatic Cyst Ethanol Injection

EUS-guided lavage of a pancreatic cyst with ethanol solution. The ethanol solution was diluted to 80% using normal saline. Final solution also contained 1% lidocaine except in patients allergic to local anesthetics. The ethanol solution was injected into

DRUG: Ethanol

  • EUS-guided lavage of a pancreatic cystic neoplasm with ethanol solution. Ethanol was diluted to 80% using normal saline.

DRUG: Lidocaine

  • The final solution contained 1% lidocaine except in subjects allergic to local anesthetics.
Primary Outcome MeasuresMeasure DescriptionTime Frame
Number of Participants With Adverse Events as a Measure of Safety and TolerabilityAdverse events include pancreatitis, bleeding, perforation, any other occurrence resulting in hospitalization, medical treatment, surgery, death, or disability1 year after final treatment
Number of Subjects With Complete or Partial Ablation of the Treated CystComplete or partial ablation of cysts will be defined by the presence of a persistent cystic structure, and its volume and maximum diameter, as determined by cross-sectional imaging studies (CT, MR)1 year after final treatment
Secondary Outcome MeasuresMeasure DescriptionTime Frame

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    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

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • PRINCIPAL_INVESTIGATOR: Mark Topazian, MD, Mayo Clinic

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    • Gomez V, Takahashi N, Levy MJ, McGee KP, Jones A, Huang Y, Chari ST, Clain JE, Gleeson FC, Pearson RK, Petersen BT, Rajan E, Vege SS, Topazian MD. EUS-guided ethanol lavage does not reliably ablate pancreatic cystic neoplasms (with video). Gastrointest Endosc. 2016 May;83(5):914-20. doi: 10.1016/j.gie.2015.08.069. Epub 2015 Sep 9.