title: Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer.
abstract: OBJECTIVE
  Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) and celiac plexus neurolysis (CPN) have become important interventions in the management of pain due to chronic pancreatitis and pancreatic cancer. However, only a few well-structured studies have been performed to evaluate their efficacy. Given limited data, their use remains controversial. Herein, we evaluate the efficacy of EUS-guided CPB and CPN in alleviating chronic abdominal pain due to chronic pancreatitis and pancreatic cancer respectively.
  
  
  METHODS
  Using Medline, Pubmed, and Embase databases from January 1966 through December 2007, a thorough search of the English literature for studies evaluating the efficacy of EUS-guided CPB and CPN for the management of chronic abdominal pain due to chronic pancreatitis and pancreatic cancer was conducted, along with a hand search of reference lists. Studies that involved less than 10 patients were excluded. Data on pain relief was extracted, pooled, and analyzed.
  
  
  RESULTS
  A total of 9 studies were included in the final analysis. For chronic pancreatitis, 6 relevant studies were identified, comprising a total of 221 patients. EUS-guided CPB was effective in alleviating abdominal pain in 51.46% of patients. For pancreatic cancer, 5 relevant studies were identified with a total of 119 patients. EUS-guided CPN was effective in alleviating abdominal pain in 72.54% of patients.
  
  
  CONCLUSIONS
  EUS-guided CPB was 51.46% effective in managing chronic abdominal pain in patients with chronic pancreatitis, but warrants improvement in patient selection and refinement of technique, whereas EUS-guided CPN was 72.54% effective in managing pain due to pancreatic cancer and is a reasonable option for patients with tolerance to narcotic analgesics.
authors.affiliation: Division of Gastroenterology and Hepatology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA. Marina_s_kaufman@yahoo.com
authors.forename: Marina
authors.initials: M
authors.lastname: Kaufman
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Singh
authors.forename: Sourish
authors.initials: S
authors.lastname: Das
authors.forename: Ronald
authors.initials: R
authors.lastname: Concha-Parra
authors.forename: Jonathan
authors.initials: J
authors.lastname: Erber
authors.forename: Carlos
authors.initials: C
authors.lastname: Micames
authors.forename: Frank
authors.initials: F
authors.lastname: Gress
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy*; D001340:Autonomic Nerve Block / Q000379:methods*; D002447:Celiac Plexus; D002986:Clinical Trials as Topic; D019160:Endosonography / Q000379:methods; D006801:Humans; D010190:Pancreatic Neoplasms / Q000503:physiopathology; D050500:Pancreatitis, Chronic / Q000503:physiopathology; D012597:Sclerosing Solutions / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D012597:Sclerosing Solutions