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Gastroenterology Research and Practice
Volume 2012, Article ID 503098, 5 pages
http://dx.doi.org/10.1155/2012/503098
Clinical Study

The Efficacy and Safety of Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis for Treatment of Pain in Patients with Pancreatic Cancer

1Department of Endoscopy, Ministry of Internal Affairs Hospital, Ul. Jagielonska 44, 70-362 Szczecin, Poland
2Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, M. Curie Hospital, 71-455 Szczecin, Poland
3The Liver Unit, Pomeranian Medical University, 70-111 Szczecin, Poland

Received 23 August 2011; Accepted 23 October 2011

Academic Editor: Fauze Maluf-Filho

Copyright © 2012 Anna Wiechowska-Kozłowska 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

Introduction. Celiac plexus neurolysis is used in pain management of patients with advanced and unresectable pancreatic cancer. We retrospectively analyzed efficacy and safety of endoscopic ultrasound- (EUS-) guided celiac plexus neurolysis in patients treated in our unit. Methods. Twenty nine subjects with unresectable pancreatic cancer and severe pain despite pharmacological treatment underwent EUS-guided celiac plexus neurolysis with 98% ethanol. Patients scored their pain according to a 0–10 point scale and were interviewed 1-2 weeks and 2-3 months after the procedure. Results. Twenty five (86%) patients reported improvement in their pain at 1-2 weeks following the procedure. Of these, 7 (24%) reported substantial improvement (decrease in pain by more than 50%) and 4 (14%) complete disappearance of pain. Pain relief was still present in 76% of patients after 2-3 months. Treatment-related side effects included hypotonia in 1 patient, severe pain immediately postprocedure in 2 patients, and short episodes of diarrhea in 3 patients. Conclusion. Endoscopic ultrasound- (EUS-) guided celiac plexus neurolysis is a safe and effective treatment of severe pain from advanced pancreatic cancer.