Endoscopic Ultrasound-Guided Chemoablation for the Treatment of Pancreatic Cysts

Inclusion Criteria

• •Age \> 18 years
• •A diagnosis of a PCN confirmed by EUS-FNA including cyst fluid next-generation sequencing (NGS) and/or EUS-needle based confocal laser endomicroscopy (nCLE) and/or EUS-through the needle biopsy (TTNB)
• •The pancreatic cystic lesion (PCL) measures at least 1 cm in diameter on CT, MRI/MRCP, or EUS
• •This cohort may include patients with PCNs previously treated with other ablative modalities include EUS-radiofrequency ablation (RFA) (NCT05961982, institutional review board \[IRB\]: 2023C0004) or EUS-pulsed electric field (PEF) (IRB 20251089) who have shown either no response or only a partial response to therapy
• •The patient is not a surgical candidate. Common clinical scenarios include-
• •* Cirrhosis of the liver (common clinical scenario)
• •* Advanced (≥ 75 years) age (common clinical scenario)
• •* Morbid obesity
• •* Significant cardiorespiratory comorbidity
• •* Patient's choice (patient elects for non-surgical management)
• •* Other significant comorbid conditions that impose prohibitive surgical risks
• •Estimated life expectancy of at least 1 year
• •Capable of giving written informed consent or has a legally authorized representative (LAR) to consent for them
• •Women of childbearing potential must have a negative pregnancy test (serum/urine) on the day of treatment. Pregnancy testing is the routine standard of care practice in the endoscopy laboratory for all patients undergoing endoscopy and sedation for endoscopy