Pancreatic Cyst Ablation With a Monopolar Radiofrequency Ablation Probe
Pancreatic Cyst Ablation With a Monopolar Radiofrequency Ablation Probe
Pancreatic cysts (A cyst is a thin walled cavity containing fluid) were rarely reported
 previously, but have been on a rise due to advanced imaging for evaluating pancreatic lesions
 or other medical reasons has increased detection of pancreatic cysts. Study shows
 transformation of pancreatic cysts to be 10.8 for every 100,000 women and 13.8 for every
 100,000 men.

 Pancreatic cysts are divided in two groups; serous and mucinous. Serous cysts are thin walled
 cysts and are not associated with precancer. On the other hand, mucinous cysts have a
 tendency to progress to pancreatic cancer.

 Radio frequency ablation (RFA) is an alternative method used for patients who could not or
 decided to not undergo surgical removal of the cyst. This study is a standard of care study
 and no changes in regards to the procedure scheduled with the physician will be changed.
Pancreatic cysts were rarely reported previously, however, the increased use of advanced
 imaging techniques (mainly computerized topography and magnetic resonance imaging), for
 evaluating suspected pancreatic pathology or for other medical reasons has increased the
 detection of pancreatic cysts. Prevalence can range from 2.5-38% (1,3). These rates vary by
 patient's age and modality of imaging used (i.e: CT vs MRI). The rate of a malignant
 transformation in pancreatic cysts is not well known, however, very low. A study using the
 SEER data reported this rate to be 10.8 for every 100,000 women, or 13.8 for every 100,000
 men with more than 85% of malignancies being detected in patient's age 40-84 years of age.
 (4) The most common histological type was adenocarcinoma, with mucinous producing tumors
 making about 4% of all adenocarcinomas detected. Pancreatic cysts are categorized under two
 major groups; serous and mucinous. Serous cystadenomas are thin walled cysts and are not
 associated with precancer. Mucinous cysts on the other hand have various diameters and
 contain viscous fluids which have the tendency to progress to pancreatic cancer.
 Radiofrequency ablation was recently proposed as an alternative for patients who could not or
 would not undergo surgical resection. In a recent study under the title "Endoscopic
 ultrasound guided radiofrequency ablation, for pancreatic cystic neoplasms and neuroendocrine
 tumors", eight patients with pancreatic cystic lesions were recruited for the study. Six
 patients had pancreatic cystic neoplasm. Post procedure imaging in 3-6 months showed complete
 resolutions of the cysts in 2 cases after using EUS RFA. No major complications were observed
 within 48 hours after the procedure, and two patients had mild abdominal pain which was
 resolved within 3 days after the surgery. (1) Management of pancreatic cysts includes
 surgical or non-surgical, or can be observational with repeat imaging. Management type
 depends on factors including pathologic features of the cyst on imaging (cyst size, enhancing
 cyst walls, duct size…etc), and the patient's ability to undergo surgery. Older patients with
 preexisting morbidities may not be eligible for a surgical resection, thus the use of
 endoscopic ultrasound interventions maybe appropriate. Endoscopic ultrasound guided radio
 frequency ablation has been used in treating certain pancreatic lesions, with a favorable
 pancreatic outcome (5)
Inclusion Criteria:

 -Adult (18-64 yrs), Geriatric (65+ yrs)

 Exclusion Criteria:

 -  Pregnant woman

 -  Neonates

 -  Children