Computed tomography-guided celiac plexus neurolysis for intractable pain of unresectable pancreatic cancer

Abstract

Aim of this study: To appraise the value of CT-guided celiac plexus neurolysis (CPN) as an effective method for alleviating intractable pain in patients with unresectable pancreatic cancer. Patients and methods: 22 patients (their ages ranged between 45 and 73 years) with severe pain due to unresectable pancreatic cancer were subjected to CT-guided CPN by 25–30 mL of 97% ethanol via anterior approach and single puncture technique. The pain intensity scoring, both before and after the procedure, was done using the Visual Analogue Scale (VAS). Results: All patients showed a significant pain reduction after CPN (P < 0.001), with peak reduction in the first day after CPN. Also, the mean ranks of analgesic requirements showed significant reduction (P < 0.001) and this reduction in analgesic requirements was maintained up to 3 months after the CPN. Less than half of the study population (45.5%) had some post-procedural adverse events, which were minimal and transient. Conclusion: The CT-guided CPN via using anterior median approach and single puncture technique with injection of 25–30 mL of 97% of ethanol is an ideal palliative treatment for controlling severe pain caused by unresectable pancreatic cancer, with a significant reduction in the analgesic requirements. Keywords: Celiac plexus, Pain, Intractable, Pancreatic carcinoma, Tomography, Computed