Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2005; 11(32): 5010-5014
Published online Aug 28, 2005. doi: 10.3748/wjg.v11.i32.5010
Effect of NCPB and VSPL on pain and quality of life in chronic pancreatitis patients
Andrzej Basinski, Tomasz Stefaniak, Ad Vingerhoets, Wojciech Makarewicz, Lukasz Kaska, Aleksander Stanek, Andrzej J. Lachinski, Zbigniew Sledzinski
Andrzej Basinski, Department of Emergency Medicine, Medical University of Gdansk, Poland
Tomasz Stefaniak, Wojciech Makarewicz, Lukasz Kaska, Aleksander Stanek, Andrzej J. Lachinski, Zbigniew Sledzinski, Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
Ad Vingerhoets, Department of Psychology and Health, and Research Institute for Psychology and Health, Tilburg University, the Netherlands
Author contributions: All authors contributed equally to the work.
Correspondence to: Tomasz Stefaniak, MD, PhD, Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 1 Debinki Str., Gdansk PL-80-211, Poland. wujstef@amg.gda.pl
Telephone: +48-583493805 Fax: +48-583492416
Received: October 19, 2004
Revised: December 20, 2004
Accepted: December 23, 2004
Published online: August 28, 2005
Abstract

AIM: To compare the effects of neurolytic celiac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) on pain and quality of life of chronic pancreatitis (CP) patients.

METHODS: Forty-eight small duct CP patients were treated invasively with NCPB (n = 30) or VSPL (n = 18) in two non-randomized, prospective, case-controlled protocols due to chronic pain syndrome, and compared to a control group who were treated conservatively (n = 32). Visual analog scales were used to assess pain and opioid consumption rate was evaluated. In addition, the quality of life was measured using QLQ C-30 for NCPB and FACIT for VSPL. Although both questionnaires covered similar problems, they could not be compared directly one with another. Therefore, the studies were compared by meta-analysis methodology.

RESULTS: Both procedures resulted in a significant positive effect on pain of CP patients. Opioids were withdrawn totally in 47.0% of NCPB and 36.4% of VSPL patients, and reduced in 53.0% and 45.4% of the respective patient groups. No reduction in opioid usage was observed in the control group. In addition, fatigue and emotional well-being showed improvements. Finally, NCPB demonstrated stronger positive effects on social support, which might possibly be attributed to earlier presentation of patients treated with NCPB.

CONCLUSION: Both invasive pain treatment methods are effective in CP patients with chronic pain.

Keywords: Chronic pancreatitis; Pain; Neurolytic celiac plexus block; Videothoracoscopic splanchnicectomy; Quality of life