title: Splanchnicectomy for pancreatic cancer pain.
abstract: Persistent pain is a serious problem that often contributes to a poor quality of life in pancreatic cancer patients. Medical management by opioid analgesics is often accompanied by side effects and incomplete pain relief. A celiac plexus block is a simple treatment which relieves pain, but the procedure demands a certain degree of proficiency and the duration of the effects obtained can be rather limited. Transhiatal bilateral splanchnicectomy achieves a certain denervation of splanchnic nerves, but it requires a laparotomy. Unilateral thoracoscopic splanchnicectomy is a minimally invasive procedure to cause definite denervation. Bilateral thoracoscopic splanchnicectomy is recommended for unsatisfactory cases or recurrent pain occurring after the initial unilateral splanchnicectomy. It is important to select the most suitable treatment depending on patients' actual medical state and the predicted outcomes.
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kuramoto
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeshima
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D003714:Denervation / Q000379:methods*; D006801:Humans; D010146:Pain / Q000601:surgery*; D059408:Pain Management; D010190:Pancreatic Neoplasms / Q000601:surgery*; D013153:Splanchnic Nerves / Q000601:surgery*; D013562:Sympathectomy / Q000379:methods*