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Endosonography-guided celiac plexus neurolysis

M J Wiersema1, L M Wiersema

  • 1Department of Medicine, St. Vincent Hospitals, Indianapolis, Indiana, USA.

Gastrointestinal Endoscopy
|December 1, 1996
PubMed
Summary
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Endosonography-guided celiac plexus neurolysis (EUS CPN) safely and effectively reduces pain in patients with intra-abdominal malignancies. This minimally invasive procedure offers significant pain relief and reduced medication needs.

Area of Science:

  • Interventional Gastroenterology
  • Pain Management
  • Oncology

Background:

  • Intra-abdominal malignancies often cause severe pain, necessitating effective pain management strategies.
  • Endoscopic ultrasound (EUS) offers advanced visualization for targeted interventions.
  • Celiac plexus neurolysis (CPN) is a technique to alleviate abdominal pain.

Purpose of the Study:

  • To evaluate the safety and efficacy of EUS-guided CPN for managing pain in patients with intra-abdominal malignancies.
  • To assess the impact of EUS CPN on pain scores and analgesic requirements.

Main Methods:

  • Thirty patients with malignancy-related upper abdominal pain were included.
  • EUS-guided CPN was performed using a linear array endoscope and a specialized needle catheter.

Related Experiment Videos

  • The celiac plexus was injected with bupivacaine and dehydrated alcohol via a transgastric approach.

    • Main Results:

    • Significant reductions in pain scores were observed at 2, 4, 8, and 12 weeks post-procedure.
    • 82-91% of patients required the same or less pain medication.
    • 79-88% of patients experienced persistent pain improvement, with minor transient diarrhea as the main complication.

    Conclusions:

    • EUS-guided CPN is a safe and effective method for pain control in patients with intra-abdominal cancers.
    • The procedure can be performed in an outpatient setting concurrently with EUS staging.
    • This technique provides a valuable option for improving quality of life in cancer patients experiencing abdominal pain.