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Systemic Effect of Endoscopic Ultrasonography-Guided Pancreatic Cyst Ablation with Ethanol and Paclitaxel

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Abstract

Background

Endoscopic ultrasonography (EUS)-guided pancreatic cyst ablation is a minimally invasive treatment modality. Local injection of ablative agents may rarely cause systemic effects in patients.

Aims

This study aimed to evaluate the systemic effect of ablative agents by analyzing the plasma drug concentration.

Methods

Ten patients with pancreatic cysts were enrolled. Cyst ablation was performed by 99 % ethanol lavage (2.5–70 mL) and paclitaxel (Genexol-polymeric micelle, 6.0–24.0) injection. Blood samples were collected at 0, 2, 4, 7 and 24 h. Plasma paclitaxel concentration was analyzed by a liquid chromatography-tandem mass spectrometry with the lowest limit of quantitation of 0.1 ng/mL. Procedure-related complications were closely monitored.

Results

Pancreatic cysts were located at the head in two, body in seven and tail in one patient. Eight cysts were septated. Median diameter and original volume were 39.5 mm (range 2.7–21.8) and 14.79 mL (3.42–343.30). Median cyst fluid CEA and amylase values were 17.10 ng/mL (0.5–14127.5) and 73.50 U/L (3.1–91,590). Peak plasma paclitaxel concentration values were observed between 2 and 7 h, ranging from 0.45 to 14.73 ng/mL. The highest concentration (17.10 ng/mL at 0 h) was observed in a patient who had intracystic bleeding. Mild abdominal pain occurred in five patients and vomiting in one patient during the first 48-h monitoring.

Conclusion

Plasma paclitaxel concentration after EUS-guided pancreatic cyst ablation was nearly as low as the undetectable value and rarely caused systemic side-effect.

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Abbreviations

EUS:

Endoscopic ultrasound

FNA:

Fine needle aspiration

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Authors and Affiliations

  1. Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea

    Hyoung-Chul Oh

  2. Division of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 42 Songpa-gu, Seoul, 138-736, Korea

    Dong Wan Seo

  3. Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea

    Su-Hui Kim

  4. Analytical Science Center, Samyang Biopharmaceuticals Corporation, Daejeon, Korea

    Bumchan Min & Jiyeong Kim

Authors
  1. Hyoung-Chul Oh
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  2. Dong Wan Seo
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  3. Su-Hui Kim
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  4. Bumchan Min
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  5. Jiyeong Kim
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Corresponding author

Correspondence to Dong Wan Seo.

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Oh, HC., Seo, D.W., Kim, SH. et al. Systemic Effect of Endoscopic Ultrasonography-Guided Pancreatic Cyst Ablation with Ethanol and Paclitaxel. Dig Dis Sci 59, 1573–1577 (2014). https://doi.org/10.1007/s10620-014-3037-2

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  • DOI: https://doi.org/10.1007/s10620-014-3037-2

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