Pain affecting procedures in non-resectable pancreatic carcinoma

Area of Science:

• Oncology
• Pain Management
• Gastroenterology

Background:

• Pancreatic cancer is a significant gastrointestinal malignancy in Bulgaria, with pain being a primary symptom.
• Effective pain management is crucial for improving the quality of life in patients with nonresectable pancreatic cancer.

Purpose of the Study:

• To present interventional and surgical techniques for pain control in nonresectable pancreatic cancer.
• To share experience in improving patient quality of life through pain management.

Main Methods:

• Thoracoscopic splanchnicectomy (bilateral and unilateral).
• Intraoperative celiac ganglion resection.
• CT-controlled celiac plexus neurolysis.
• Epidural analgesia.
• Quality of life assessment using the 'City of Hope' questionnaire and Visual Analogue Scale (VAS).

Main Results:

• Bilateral thoracoscopic splanchnicectomy and intraoperative celiac ganglion removal provided the longest duration of pain relief.
• CT-controlled celiac plexus neurolysis and epidural analgesia offered shorter-term pain management.
• All evaluated techniques demonstrated a correlation between pain reduction (VAS) and improved quality of life.

Conclusions:

• Surgical and interventional methods are valuable for controlling cancer pain and enhancing the quality of life for pancreatic cancer patients.
• Further research into novel pain control strategies is warranted.