title: Percutaneous radiofrequency ablation of the splanchnic nerves in patients with chronic pancreatitis: results of single and repeated procedures in 11 patients.
abstract: BACKGROUND
  Pain is a major problem for chronic pancreatitis (CP) patients. Unfortunately, medical therapy often fails. Endoscopic and surgical treatments are invasive, and results vary. Percutaneous radiofrequency ablation of the splanchnic nerves (RFSN) is a relatively new and minimally invasive procedure for treatment of intractable pain in CP patients.
  
  
  METHODS
  We retrospectively evaluated 18 RFSN procedures in 11 CP patients, all refractory to analgesics. Five patients underwent a second procedure; two patients underwent a third procedure. NRS pain scores were assessed. Complications, analgesics usage, and length of the pain-free period were recorded.
  
  
  RESULTS
  Radiofrequency ablation of the splanchnic nerves was effective in 15/18 interventions. The mean NRS pain score decreased from 7.7 ± 1.0 to 2.8 ± 2.7 (P ≤ 0.001). The pain-free period lasted for a median period of 45 weeks. The effect of repeated interventions was comparable to the initial procedure. One transient side effect was reported. Four patients reported significantly reduced analgesic usage; 4 patients completely stopped their pain medication.
  
  
  CONCLUSIONS
  Radiofrequency ablation of the splanchnic nerves is a minimally invasive, effective procedure for pain relief. After the effect has subsided, RFSN can be successfully repeated. RFSN might become an alternative treatment in a selected group of CP patients. A larger, randomized trial is justified to substantiate these findings.
authors.affiliation: Department of Gastroenterology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Bas P M
authors.initials: BP
authors.lastname: Verhaegh
authors.forename: Maarten
authors.initials: M
authors.lastname: van Kleef
authors.forename: José W
authors.initials: JW
authors.lastname: Geurts
authors.forename: Martine
authors.initials: M
authors.lastname: Puylaert
authors.forename: Jan
authors.initials: J
authors.lastname: van Zundert
authors.forename: Alphons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Ad A M
authors.initials: AA
authors.lastname: Masclee
authors.forename: Yolande C A
authors.initials: YC
authors.lastname: Keulemans
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D059408:Pain Management / Q000379:methods; D010148:Intractable Pain / Q000209:etiology* / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D013153:Splanchnic Nerves / Q000601:surgery*
keywords: chronic pancreatitis; pain; radiofrequency ablation; splanchnic nerves