title: Anatomical analysis of computed tomography images for determining the optimal oblique fluoroscope angle for percutaneous coeliac plexus block.
abstract: This retrospective study used abdominal computed tomography (CT) scan images to determine the optimal safe oblique angle for fluoroscopy in fluoroscope-assisted coeliac plexus block (CPB). Abdominal CT scans from 131 patients were included in the study: 42 patients with cancer of the  pancreas head, 45 with cancer of the pancreas body and tail and 44 with chronic pancreatitis. The oblique angle and entry distance from the midline were measured at the T12 and L1 levels, and the safe angle range that avoided puncture of the organs was also measured. The optimal angle varied  between the T12 and L1 levels, and between the right and left sides at the T12 level. There was no difference in the oblique angle between the patient groups. The optimal oblique angle for fluoroscopy was determined to be 17° for right T12, 18° for left T12, and 19° for both left  and right L1.
authors: Department of Anaesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, Republic of Korea.
authors: W H
authors: WH
authors: Kim
authors: C J
authors: CJ
authors: Lee
authors: W S
authors: WS
authors: Sim
authors: B S
authors: BS
authors: Shin
authors: H J
authors: HJ
authors: Ahn
authors: H Y
authors: HY
authors: Lim
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001340:Autonomic Nerve Block / Q000379:methods*; D002447:Celiac Plexus / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000503:physiopathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000503:physiopathology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013131:Spine / Q000000981:diagnostic imaging; D013813:Therapy, Computer-Assisted; D014057:Tomography, X-Ray Computed