How to improve the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis in pain management in patients with pancreatic cancer: analysis in a single center.
Visceral pain secondary to pancreatic cancer is often difficult to control and poses a challenge to the physician. We retrospectively analyzed the efficacy and safety of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with unresectable pancreatic cancer. Forty-one patients with severe pain despite treatment with opioids underwent EUS-CPN with absolute alcohol. Patients scored their pain on a scale of 0 to 10 and were interviewed after the procedure. Of the 41 patients, 33, 37, and 25 patients reported improvement in their pain within 3 days, at 1 week, and at 3 months, respectively, following the procedure. Of all the patients, 19 patients reported substantial improvement and 4 patients showed complete disappearance of pain. Complication appeared in 2 patients with transient hypotension. In our study, EUS-CPN is a safe and effective form of treatment for intractable pain secondary to advanced pancreatic cancer.
*Department of General Surgery, Pancreatic Disease Institution †Department of Gastroenterology and Digestive Endoscopy, Huashan Hospital, Fudan University, Shanghai, P.R. China.
Hao
H
Si-Jie
Xu
X
Wei-Jia
Di
D
Yang
Yao
Y
Lie
Yang
Y
Feng
Jiang
J
Yong-Jian
Li
L
Ji
Jin
J
Chen
Zhong
Z
Liang
Fu
F
De-Liang
D000368:Aged; D001340:Autonomic Nerve Block; D002447:Celiac Plexus; D019160:Endosonography; D000431:Ethanol; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010190:Pancreatic Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D059265:Visceral Pain / Q000209:etiology / Q000628:therapy*
D000431:Ethanol