Endoscopic ultrasound-guided celiac neurolysis.
Intractable abdominal pain commonly develops in patients with pancreatic cancer. Oral pharmacologic therapy is ineffective for many patients and side effects commonly occur. Celiac neurolysis (CN) is sometimes performed to enhance pain relief. Percutaneous approaches were initially described, with endoscopic ultrasound (EUS)-guided CN more recently introduced. There is uncertainty regarding the efficacy and role of CN in managing pancreatic cancer pain, but CN should still be considered in this difficult-to-treat cohort of patients. EUS-guided approaches may be favored when EUS is otherwise indicated for diagnostic or staging purposes. When EUS is not otherwise indicated, percutaneous approaches are likely favored.
Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. levy.michael@mayo.edu
Michael J
MJ
Levy
Suresh T
ST
Chari
Maurits J
MJ
Wiersema
D015746:Abdominal Pain / Q000209:etiology* / Q000628:therapy*; D001340:Autonomic Nerve Block; D002045:Bupivacaine; D002447:Celiac Plexus; D019160:Endosonography; D005728:Ganglia, Sympathetic; D006801:Humans; D008012:Lidocaine; D010190:Pancreatic Neoplasms / Q000209:etiology*; D018084:Ultrasonography, Interventional
D008012:Lidocaine; D002045:Bupivacaine