Endoscopic ultrasound-guided celiac plexus neurolysis for managing abdominal pain related with advanced cancer

Abstract

Cancer associated abdominal pain, as typified by pancreatic cancer, has conventionally been treated with narcotic drugs, but often the severe abdominal pain is difficult to control. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is commonly performed for abdominal pain that is difficult to control. EUS-CPN can be performed more safely and reliably than other conventional procedures on the celiac plexus, and good outcomes of pain relief have been reported. Although a variety of endoscopic techniques are available for EUS-CPN, the choice varies among institutions, and evidence on the efficacy and safety of each procedure is limited. In this review, we summarize the indications for treatment, specific endoscopic techniques, therapeutic efficacy for pain relief, and complications from previous reports on EUS-CPN.

Keywords

• chronic pancreatitis; endoscopic ultrasound-guided celiac ganglia neurolysis; endoscopic ultrasound-guided celiac plexus neurolysis; pancreatic cancer