Continuing experience with palliative chemical splanchnicectomy

Forty-one patients underwent open phenol splanchnicectomy for control of pain at the time of initial laparotomy for what was thought to be unresectable pancreatic carcinoma. Twenty-three patients underwent concomitant biliary and/or intestinal bypass procedures. In no patient was laparotomy performed only for the purpose of performing splanchnicectomy. The operative mortality was 15%. In no patient could the addition of splanchnicectomy be implicated as the cause of death. Eighty-eight per cent of patients experienced relief of pain postoperatively. The mean duration of pain control was 4.3 months. The mean postoperative survival was five months. No postoperative complications could be attributed to the addition of splanchnicectomy. Open phenol splanchnicectomy is a highly successful and safe ancillary procedure for control of pain and is recommended at the time of initial laparotomy in patients found to have advanced intra-abdominal neoplasm.