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World J Gastroenterol. Jan 7, 2014; 20(1): 110-117
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.110
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.110
Celiac plexus neurolysis in pancreatic cancer: The endoscopic ultrasound approach
Andrada Seicean, Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400162 Cluj-Napoca, Romania
Author contributions: Seicean A solely wrote this manuscript.
Correspondence to: Andrada Seicean, MD, PhD, Associate Professor, Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, University of Medicine and Pharmacy “Iuliu Hatieganu”, Croitorilor Street 19-21, 400162 Cluj-Napoca, Romania. andradaseicean@yahoo.com
Telephone: +40-74-4332107 Fax: +40-26-4431758
Received: October 3, 2013
Revised: November 1, 2013
Accepted: November 18, 2013
Published online: January 7, 2014
Processing time: 109 Days and 12.3 Hours
Revised: November 1, 2013
Accepted: November 18, 2013
Published online: January 7, 2014
Processing time: 109 Days and 12.3 Hours
Core Tip
Core tip: Endoscopic ultrasound-guided celiac plexus neurolysis should be considered as the adjunct method to standard pain management. It moderately reduces pain in pancreatic cancer, without eliminating it. Nearly all patients need to continue opioid use, often at a constant dose. The central technique is easy to perform, but intraganglia injection seems to give better results. This review focuses on methods of celiac neurolysis, with details about endoscopic ultrasound-guided celiac plexus neurolysis, indications and outcomes with regard to efficacy and safety, novel techniques, and predictors of pain response.