Abstract

Objective To prospectively assess the efficacy and safety of endoscopic ultrasoundguided celiac plexus neurolysis (EUS-CPN) in the management of pain caused by pancreatic carcinoma. Methods Patients with confirmed un-resectable pancreatic malignancy were treated with EUS-CPN once or twice. The data including age, gender, pain duration, opioid consumption, tumor location, pain scores before and after the procedure, number of treatment, duration of pain relief and survival time were collected. Results A total of 27 cases with cancerous abdominal pain were recruited. The median pain scores were significantly lower after EUS-CPN, and pain relief was obtained in 81.5% (95% CI, 66. 8% -96. 1% ) patients with a median duration of 56.0 days (95% CI, 17.1-94. 9) , whose confidence interval was compara- ble to that of survival time (97. 0 days, 95% CI, 82. 7-111.3). No clinical factors could predict post-procedure duration of pain relief (X2 = 6. 757, P = 0. 239). Procedure-related transient diarrhea and fever were noted only in 1 patient. No major complications occurred. Conclusion EUS-guided CPN is safe and effective in alleviating abdominal pain associated with pancreatic cancer, even at the late stage. Moreover, no clinical factor could predict post-procedure degree or duration of pain relief. Key words: Pancreatic neoplasms; Endoscopic ultrasonography; Nerve block; Pain measurement

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