Palliation of pain in chronic pancreatitis. Use of neural blocks and neurotomy.
Effective management of the pain of chronic pancreatitis may require a multidisciplinary approach involving gastroenterologists, anesthesiologists, psychologists or counselors for chemical addiction (alcohol, narcotics), and surgeons. Viable approaches use pharmacologic analgesics with selected psychotropic medications, celiac plexus blocks, and possibly thoracoscopic splanchnic nerve transections. If these management techniques that preserve pancreatic parenchyma and function, fail, resective surgical therapy may be indicated. For most of these patients, all attempts at nonresective therapy should be exhausted before operative intervention.
Wong
G Y
GY
Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minnesota, USA.
Sakorafas
G H
GH
Tsiotos
G G
GG
Sarr
M G
MG
D000700:Analgesics / Q000008:administration & dosage*; D002447:Celiac Plexus; D002908:Chronic Disease; D003714:Denervation / Q000379:methods*; D006801:Humans; D009407:Nerve Block / Q000379:methods*; D010148:Intractable Pain / Q000209:etiology* / Q000517:prevention & control*; D010179:Pancreas / Q000098:blood supply / Q000294:innervation; D010195:Pancreatitis / Q000150:complications* / Q000601:surgery; D018579:Patient Selection; D013153:Splanchnic Nerves / Q000187:drug effects / Q000601:surgery; D013563:Sympathectomy, Chemical; D013906:Thoracoscopy
D000700:Analgesics