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World J Gastroenterol. Mar 7, 2014; 20(9): 2186-2192
Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2186
Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2186
Celiac plexus neurolysis in the management of unresectable pancreatic cancer: When and how?
Jonathan M Wyse, Division of Gastroenterology, Jewish General Hospital, McGill University, Montreal H3T 1E2, Quebec, Canada
Yen-I Chen, McGill University Health Center, McGill University, Montreal H3A 1A1, Quebec, Canada
Anand V Sahai, Division of Gastroenterology, Hopital Saint Luc, Centre Hospitaliér de l’Universite de Montréal, Montreal H2X 1P1, Quebec, Canada
Author contributions: All author contributed equally to the preparation of this manuscript.
Correspondence to: Jonathan M Wyse, MD, MSc, Division of Gastroenterology, Jewish General Hospital, McGill University, 3755 Chemin de la Cote-Ste-Catherine, Montreal H3T 1E2, Quebec, Canada. jonathan.wyse@mcgill.ca
Telephone: +1-514-3408286 Fax: +1-514-3408282
Received: October 28, 2013
Revised: December 27, 2013
Accepted: January 3, 2014
Published online: March 7, 2014
Processing time: 129 Days and 3.1 Hours
Revised: December 27, 2013
Accepted: January 3, 2014
Published online: March 7, 2014
Processing time: 129 Days and 3.1 Hours
Core Tip
Core tip: The efficacy of salvage celiac plexus neurolysis (CPN) either by percutaneous or endoscopic ultrasound (EUS) guided technique has been modest in its ability to reduce pain and narcotic requirements in patients with unresectable pancreatic cancer, and few studies with rigorous methodology exist. Data for early EUS-CPN at time of diagnosis appears to prevent pain escalation while moderating narcotic use and future studies should explore CPN for patients before rescue therapy is needed. Reports of serious and fatal complications of CPN have surfaced in recent years.