Position statement on EUS-guided ablation of pancreatic cystic neoplasms from an international expert panel

Anthony Yuen-Bun Teoh; Dong Wan Seo; William Brugge; John Dewitt; Pradermchai Kongkam; Enqiang Linghu; Matthew T. Moyer; Ji Kon Ryu; Khek Yu Ho

doi:10.1055/a-0959-5870

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(09): E1064-E1077
DOI: 10.1055/a-0959-5870

Review

Position statement on EUS-guided ablation of pancreatic cystic neoplasms from an international expert panel

Authors

Anthony Yuen-Bun Teoh

¹Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
Dong Wan Seo

²Department of Gastroenterology, Asan Medical Centre, Seoul, Korea
William Brugge

³Pancreas Biliary Center, Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, United States
John Dewitt

⁴Division of Gastroenterology, Department of Medicine, Indiana University Hospital, Indianapolis, Indiana, United States
Pradermchai Kongkam

⁵Pancreas Research Unit and Gastrointestinal Endoscopy Excellent Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Enqiang Linghu

⁶Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
Matthew T. Moyer

⁷Division of GI-Hepatology and Penn State University Cancer Institute, Penn State Hershey Medical Center, Hershey, Pennsylvania, United States
Ji Kon Ryu

⁸Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Khek Yu Ho

⁹Department of Medicine, National University of Singapore, Singapore

Abstract

Background and aim Recently, several guidelines with divergent recommendations on management of pancreatic cystic neoplasm have been published but the role of endoscopic ultrasound (EUS)-guided pancreatic cyst ablation has not been thoroughly addressed. The aim of the current paper is to explore the issues surrounding EUS-guided pancreatic cyst ablation by generating a list of clinical questions and providing answers based on best scientific evidence available.

Methods An expert panel in EUS-guided pancreatic cyst ablation was recruited from members of the Asian EUS group and an international expert panel. A list of clinical questions was created and each question allocated to one member to generate a statement in response. The statements were then discussed in three Internet conference meetings between October 2016 and October 2017. The statements were changed until consensus was obtained. Afterwards, the complete set of statements was sent to all the panelist to vote on strength of the statements, classification of the statement sand grading of the evidence.

Results Twenty-three statements on EUS-guided drainage of pancreatic cyst ablation were formulated. The statements addressed indications for the procedures, technical aspects, pre-procedure and post-procedure management, management of complications, and competency and training in the procedures.

Conclusion The current set of statements on EUS-guided pancreatic cyst ablation are the first to be published by any endoscopic society. Clinicians interested in developing the technique should reference these statements and future studies should address the key issues raised in the document.

Full Text

References

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