Effect of NCPB and VSPL on pain and quality of life in chronic pancreatitis patients.
OBJECTIVE
To compare the effects of neurolytic celiac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) on pain and quality of life of chronic pancreatitis (CP) patients.


METHODS
Forty-eight small duct CP patients were treated invasively with NCPB (n = 30) or VSPL (n = 18) in two non-randomized, prospective, case-controlled protocols due to chronic pain syndrome, and compared to a control group who were treated conservatively (n = 32). Visual analog scales were used to assess pain and opioid consumption rate was evaluated. In addition, the quality of life was measured using QLQ C-30 for NCPB and FACIT for VSPL. Although both questionnaires covered similar problems, they could not be compared directly one with another. Therefore, the studies were compared by meta-analysis methodology.


RESULTS
Both procedures resulted in a significant positive effect on pain of CP patients. Opioids were withdrawn totally in 47.0% of NCPB and 36.4% of VSPL patients, and reduced in 53.0% and 45.4% of the respective patient groups. No reduction in opioid usage was observed in the control group. In addition, fatigue and emotional well-being showed improvements. Finally, NCPB demonstrated stronger positive effects on social support, which might possibly be attributed to earlier presentation of patients treated with NCPB.


CONCLUSIONS
Both invasive pain treatment methods are effective in CP patients with chronic pain.
Basinski
Andrzej
A
Department of Emergency Medicine, Medical University of Gdansk, Gdansk PL-80-211, Poland.
Stefaniak
Tomasz
T
Vingerhoets
Ad
A
Makarewicz
Wojciech
W
Kaska
Lukasz
L
Stanek
Aleksander
A
Lachinski
Andrzej J
AJ
Sledzinski
Zbigniew
Z
D000328:Adult; D001340:Autonomic Nerve Block / Q000379:methods*; D016022:Case-Control Studies; D002447:Celiac Plexus / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D013153:Splanchnic Nerves / Q000601:surgery*