Computed Tomography-Guided Celiac Plexus Block and Neurolysis: Technical Outcomes and Complications

Area of Science:

• Interventional Pain Management
• Gastroenterology
• Oncology

Background:

• Celiac plexus block (CPB) and celiac plexus neurolysis (CPN) are established interventions for chronic abdominal pain, particularly in pancreatic cancer and chronic pancreatitis.
• These procedures have demonstrated efficacy in reducing pain and opioid consumption in cancer patients.
• Limited data exists on technical variations and complications associated with CPB and CPN.

Purpose of the Study:

• To investigate technical factors influencing celiac plexus block and neurolysis outcomes.
• To analyze patient demographics and procedural complications associated with CPB and CPN.
• To evaluate the efficacy of CPB/CPN in patients with malignant and nonmalignant abdominal pain.

Main Methods:

• Retrospective analysis of 141 patients undergoing CPB and/or CPN between September 2017 and February 2023.
• Computed tomography-guided procedures using lidocaine or ethanol injections.
• Data collection included demographics, indications, technique, and complications; patients stratified by pain etiology (malignant vs. nonmalignant).

Main Results:

• 70.2% of patients received treatment for malignancy-related pain.
• No significant differences in technical parameters were observed between groups.
• Low rates of side effects (hypotension, diarrhea, localized pain) were reported, consistent with existing literature; 67.4% experienced subjective pain improvement.

Conclusions:

• CPB and CPN are effective in managing both malignant and nonmalignant chronic abdominal pain.
• The study provides valuable insights into patient data, technical variables, and procedural complications.
• Further research with standardized pain scoring is warranted to optimize patient outcomes.