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BioMed Research International
Volume 2014, Article ID 941726, 8 pages
http://dx.doi.org/10.1155/2014/941726
Review Article

Splanchnicectomy for Pancreatic Cancer Pain

1Department of Surgery, Kumamoto General Hospital, Japan Community Health Care Organization, 10-10 Tohri-cho, Yatsushiro, Kumamoto 866-8660, Japan
2Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan

Received 7 March 2014; Accepted 5 April 2014; Published 27 April 2014

Academic Editor: Roberto Cirocchi

Copyright © 2014 Toshiro Masuda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.