Abstract
Purpose The current WHO policy for treating patients with pain from pancreas cancer is sequential pharmacologic (NSAID-opioids) treatment. If this fails, neurolytic (alcohol) celiac plexus block (NCPB) is appropriate to achieve pain relief. However, if NCPB also fails, not many other non-invasive treatments are available. The aim of our study was to evaluate the efficiency and safety of percutaneous CT guided cryoablation of the celiac plexus in treating patients with intractable abdominal pain caused by advanced adenocarcinoma of the pancreas. Materials and Methods In a prospective study, from January 2010 to March 2012, 6 consecutive patients with advanced adenocarcinoma and intractable pain were enrolled. IRB approval was obtained. A 17-gauge 17 cm cryoablation probe (Galil Medical Inc. Arden Hills, MN) was placed into the expected location of the celiac plexus via a left paraspinal approach under CT guidance and two cycles of freeze-thaw were performed. All patients were admitted for overnight observation. They were followed in 24 hours, one week and one month intervals for complications and pain. Pain was evaluated with subjective pain scoring using a visual analog scale; VAS; 0-10. Results Mean patients’ pain was 8.5 out of 10 (subjective pain scoring using a visual analog scale; VAS; 0-10; pain range of 8 to 10) which significantly decreased to 3.5 (range 3-4; p Conclusion Percutaneous cryoablation is an effective and safe alternative to neurolytic (alcohol) celiac plexus block for palliative treatment of intractable abdominal pain in patients with metastatic pancreatic carcinoma.
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