Endoscopic ultrasound-guided treatments: Are we getting evidence based - a systematic review

Table 8 Endoscopic ultrasound-guided plexus neurolysis/celiac plexus block n (%)

Ref.	Design	Indications	Techniques	Technical success	Clinical success (pain relief)	Complications
Wiersema et al[167]	RS	PC (n = 25)	CPN	100%	79%-88%	4 transient diarrhea
		Metastases (n = 5)
Gress et al[163]	RCT	CP (n = 10)	EUS-guided	100%	50%	None
		CP (n = 8)	CT-guided		25%
Gunaratnam et al[168]	PS	PC (n = 58)	CPN	100%	78%	5 transient abdominal pain
Gress et al[169]	PS	CP (n = 90)	CPB	100%	55%	3 diarrhea
Tran et al[170]	RS	PC (n = 10)	CPN	100%	70%	NR
Ramirez-Luna et al[171]	RS	PC (n = 11)	CPN	100%	72.20%	None
Levy et al[172]	RS	PC (n = 18)	CGN (n = 17)	NR	16/17 (94)	12 hypotension
			CGB (n = 1)		0/1 (0)	6 diarrhea
		CP (n = 18)	CGN (n = 5)	NR	4/5 (80)
			CGB (n = 13)		5/13 (38)
O'Toole et al[173]	RS	PC (n = 2)	CPB (n = 189)	NR	NR	2 post-procedural pain
		CP (n = 187)				1 retroperitoneal abscess
		PC (n = 21)	CPN (n = 31)	NR	NR	1 hypotension
		CP (n = 10)
Santosh et al[164]	RCT	CP (n = 27)	EUS-CPB	100%	70%	2 diarrhea
		CP (n = 29)	Percutaneous-CPB	-	30%
Leblanc et al[165]	RCT	CP (n = 23)	CPB (central)	100%	15/23 (65)	None
		CP (n = 27)	CPB (bilateral)		16/27 (59)
Sahai et al[174]	RS	PC (n = 34)/CP (n = 37)	Central CPN	100%	45.90%	1 adrenal artery bleeding
		PC (n = 45)/CP (n = 44)	Bilateral CPN		70.40%
Sakamoto et al[175]	PS	PC (n = 67)	34CPN	100%	72%-79%	None
			33 BPN	96.90%	19%-78%
Wyse et al[158]	RCT	PC (n = 96)	48 CPN	100%	60.70%	None
			48 control	-	-
LeBlanc et al[160]	RCT	PC (n = 29)	CPB (central)	100%	20/29 (69)	None
		PC (n = 21)	CPB (bilateral)		17/21 (81)
Téllez-Ávila et al[161]	RS	PC (n = 53)	Central (n = 21)	NR	10/21 (48)	None
			Bilateral (n = 32)		18/32 (56)
Iwata et al[176]	RS	PC (n = 47)	CPN	100%	68.10%	NR
Ascunce et al[177]	RS	PC (n = 64)	CPN	100%	50%	1 hypotension
Stevens et al[166]	RCT	CP (n = 40)	Triamcinolone + bupivacaine (n = 21)	100%	68.4%-85.7%	1 severe hypertension
			Bupivacaine (n = 19)			4 pain exacerbation
						1 gastric hematoma
Wiechowska-Kozlowska et al[178]	RS	PC (n = 29)	CPN	100%	86%	3 diarrhea
						1 hypotonia
						2 post-procedural pain
Wang et al[179]	PS	PC (n = 23)	Celiac ganglion irradiation	100%	82.60%	None
Leblanc et al[180]	PS	PC (n = 20)	10 mL (n = 10)	100%	80%	3 nausea and vomiting
			20 mL (n = 10)		100%	2 diarrhea
						1 lightheadness
Seicean et al[181]	PS	PC (n = 32)	CPN	100%	75%	NR
Doi et al[162]	RCT	PC (n = 68)	CPN (n = 34)	100%	45.50%	1 GI bleeding
			CGN (n = 34)	88.20%	73.50%	3 hypotension
						5 diarrhea
						17 pain exacerbation
Total	23 studies	1327	-	100% (88.2%-100%)	71.9% (45.5%-90%)	-

RCT: Randomized controlled trial; PS: Prospective study; RS: Retrospective study; PC: Pancreatic cancer; CP: Chronic pancreatitis; CPN: Celiac plexus neurolysis; CPB: Celiac plexus block; CT: Computed tomography; CGB: Celiac ganglia block; CGN: Celiac ganglia neurolysis; NR: Not reported.