Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis

Cancers
Kosuke MinagaMasatoshi Kudo

Abstract

The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported ...Continue Reading

References

Aug 1, 1996·Cancer·A Caraceni, R K Portenoy
Dec 1, 1996·Gastrointestinal Endoscopy·M J Wiersema, L M Wiersema
Apr 1, 1997·Gastrointestinal Endoscopy Clinics of North America·N HaradaL M Wiersema
Aug 28, 2001·Gastrointestinal Endoscopy·N T GunaratnamM J Wiersema
Jun 27, 2002·Gastrointestinal Endoscopy·Roy M SoetiknoKenneth J Chang
May 31, 2003·Gastrointestinal Endoscopy·Michael J Levy, Maurits J Wiersema
Sep 27, 2006·Endoscopy·N MuscatielloE Ierardi
Nov 15, 2006·The American Journal of Gastroenterology·Brian M Yan, Robert P Myers
Sep 26, 2007·Gastrointestinal Endoscopy·Douglas G AdlerUNKNOWN ASGE TECHNOLOGY COMMITTEE
Nov 1, 2007·The American Journal of Gastroenterology·Michael J LevySuresh T Chari
Mar 28, 2008·The Korean Journal of Internal Medicine·Tae-In HaJun-Woo Lee
Feb 21, 2009·Gastrointestinal Endoscopy·Ian D Penman
Feb 6, 2010·World Journal of Gastroenterology : WJG·Keith L ObsteinChristopher C Thompson
Sep 9, 2010·The American Journal of Gastroenterology·Hiroki SakamotoMasatoshi Kudo
Dec 17, 2010·World Journal of Gastrointestinal Endoscopy·Assaad M Soweid, Cecilio Azar
Mar 18, 2011·The Cochrane Database of Systematic Reviews·Paolo G ArcidiaconoPier A Testoni
Mar 25, 2011·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Keisuke IwataHisataka Moriwaki
Apr 5, 2012·Gastroenterology Research and Practice·Anna Wiechowska-KozłowskaPiotr Milkiewicz
Apr 11, 2012·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Savio G Barreto, Gino T P Saccone
Jul 21, 2012·Endoscopy·A Z Gimeno-GarcíaA V Sahai
Jul 24, 2012·Gastrointestinal Endoscopy·Shyam VaradarajuluShantel Hebert-Magee
Jun 28, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Werner NagelsPatrick Dobbels
Nov 8, 2013·Surgical Endoscopy·María Victoria Alvarez-SánchezBertrand Napoléon
Mar 25, 2015·Gastrointestinal Endoscopy·Larissa L Fujii-LauMichael J Levy
Nov 10, 2015·Gastrointestinal Endoscopy·Kosuke MinagaMasatoshi Kudo

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Citations

Nov 7, 2018·World Journal of Gastrointestinal Surgery·Chelsey C CiambellaThomas J Miner
Jul 3, 2021·Journal of Community Hospital Internal Medicine Perspectives·Abuzar A AsifSrinivas R Puli
Feb 11, 2021·GE Portuguese Journal of Gastroenterology·Pedro Moutinho-RibeiroMiguel Bispo

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BETA
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biopsy

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