Ethanol lavage of pancreatic cystic lesions: initial pilot study

Gastrointest Endosc. 2005 May;61(6):746-52. doi: 10.1016/s0016-5107(05)00320-2.


Background: Ethanol lavage has been used to successfully and safely ablate cystic lesions of the liver, the kidneys, and the thyroid.

Methods: Asymptomatic patients who undergo EUS examination for a pancreatic cystic lesion were eligible. Patients underwent complete examination with a linear-array echoendoscope, and cyst characteristics were documented. After evacuation of the cyst with needle aspiration, the cyst cavity was lavaged with ethanol for 3 to 5 minutes. The concentration (5%-80%) of ethanol was gradually increased over the course of the study. Patients were monitored for complications during 2 hours after the procedure, and further follow-up was obtained at 72 hours and 1 year after lavage.

Observations: Twenty-five patients were enrolled, 80% were women, and the mean age of all patients was 64.5 years. Cysts had a mean diameter of 19.4 mm and were equally located in the head, the body, and the tail of the pancreas. Cyst-fluid characteristics included high viscosity in 13 (52%) and a mean carcinoembryonic antigen and amylase of 5916 ng/mL and 11,506 U/L, respectively. None of the patients reported any symptoms in short- and long-term follow-up. Of the 23/25 patients with complete follow-up, 8 patients (35%) had complete resolution of their cysts on follow-up imaging. Five patients underwent resection, and histologic evidence of epithelial ablation was seen.

Conclusions: Ethanol lavage of pancreatic cystic lesions is safe and feasible. A subset of patients undergoing ethanol lavage appears to have long-term resolution on follow-up imaging. Further prospective studies are required to determine if ethanol lavage is an effective treatment for pancreatic cystic lesions.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use*
  • Endosonography
  • Ethanol / therapeutic use*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Cyst / diagnostic imaging
  • Pancreatic Cyst / pathology
  • Pancreatic Cyst / therapy*
  • Pilot Projects
  • Prospective Studies
  • Safety
  • Suction / methods
  • Therapeutic Irrigation / methods
  • Treatment Outcome


  • Anti-Infective Agents, Local
  • Ethanol