Introduction: Celiac plexus block (CPB) has been commonly described as a procedure for control of pain in patients with chronic pancreatic pain. We are exploring the use of CPB together with continuous wound infiltration via pre-peritoneal catheters to reduce post-operative pain after major open hepato-pancreatico-biliary surgery. Method: Five patients underwent open hepato-pancreatico-biliary surgery; 2 open liver resections via reverse L-incisions and 3 open pylorus-preserving-pancreaticoduodenectomy via rooftop incisions. For the CPB, the celiac axis was identified and 10-20mls of 0.25% Marcaine was infiltrated around the celiac axis at the end of surgery. As per standard regime, pre-peritoneal catheters were inserted and 20ml Ropivacaine 0.2% bolus was injected into each catheter to initiate the pre-peritoneal analgesia. Post-operatively, Patient-Controlled-Anlagesia (PCA) opioid was commenced. The pre-perioneal infusion were continued till post-operative day (POD) 5. The opioid consumption is tabulated in Table 1 below.EP02F-027 TablePatientOpioid Usage POD 1POD 2POD 3POD 41Oxycodone 20 mg5 mg002PCA Fentanyl 60 mcg340 mcg003PCA Morphine 16 mg41 mgPO Oxycodone 30mgPO Oxycodone 5 mg4PCA Morphine 2 mg7 mg005PCA Fentanyl 400 mcg120 mcg00 Open table in a new tab Results: The Visual Analog Score (VAS) for pain was assessed up to fourth POD. All patients had pain scores of 3 or less at rest. For VAS on movement, 2 patients had VAS of 4 to 5 on first POD. By second POD, dynamic VAS scores were 3 or less and all patients were ambulating Conclusion: Our case series demonstrate that CPB, together with pre-peritoneal infusion, helped to minimise the post-operative opioid consumption and pain of patients. Patients are able to mobilise early and this is an important measure of good pain control.