An Open Randomized Comparison of Clinical Effectiveness of Protocol-Driven Opioid Analgesia, Celiac Plexus Block or Thoracoscopic Splanchnicectomy for Pain Management in Patients with Pancreatic and Other Abdominal Malignancies

Johnson, C. D.; Berry, David P.; Harris, Scott; Pickering, RM; Davis, Carol; George, Steve; Imrie, C. W.; Neoptolemos, John P.; Sutton, Robert

doi:10.1159/000199441

Cited by 56 publications

(70 citation statements)

References 19 publications

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“…This observation has been reported in a sufficient number of patients in randomized controlled studies, prevalently in pancreatic cancer pain (Mercadante, 1993;Kawamata et al, 1996;Polati et al, 1998;Lillemoe et al, 1993;Staats et al, 2001;Okuyama et al, 2002;Wong et al, 2004;Jain et al, 2005;Zhang et al, 2008;Stefaniak et al, 2005;Wyse et al, 2001;De Oliveira et al, 2004). Only one paper did not show any difference (Johnson et al, 2009). Some controversies still remain, particularly regarding the most appropriate timing for performing such a block.…”

Section: A) Cpb or Splanchnicectomymentioning

confidence: 72%

“…Effective pain relief was achieved in about half of patients two months after the procedures, without significant differences between the groups in pain scores, opioid consumption, and adverse effects (Johnson et al, 2009). In another non-randomized study, both CPB and TS were beneficial and resulted in a better quality of life in comparison with patients treated with standard analgesic therapy (Stefaniak et al, 2005).…”

Section: A) Cpb or Splanchnicectomy Versus Analgesics Or Other Treatmmentioning

confidence: 98%

“…Pain relief was more pronounced when the blocks had been performed early, before opioid therapy or when patients were receiving anti-inflammatory drugs (Ischia et al, 1992). CPB performed with different imaging guidances and TS provided similar pain relief, opioid consumption, and adverse effects (Johnson et al, 2009). In another study, transaortic CPB was compared with posterior splanchnicectomy (S).…”

Section: C) Comparison Among Techniquesmentioning

confidence: 99%

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Sympathetic blocks for visceral cancer pain management: A systematic review and EAPC recommendations

Mercadante

Klepstad

Kurita

et al. 2015

Critical Reviews in Oncology/Hematology

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Section: A) Cpb or Splanchnicectomymentioning

confidence: 72%

Section: A) Cpb or Splanchnicectomy Versus Analgesics Or Other Treatmmentioning

confidence: 98%

Section: C) Comparison Among Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Sympathetic blocks for visceral cancer pain management: A systematic review and EAPC recommendations

Mercadante

Klepstad

Kurita

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Steroids have been shown to reduce cancer-related pain [103]. For neuropathic pain, amitriptyline, sodium valproate or gabapentin may be administered [104]. A celiac plexus block may be used for severe, intractable pain [105], and the procedure can be performed intraoperatively or guided via CT or EUS.…”

Section: Palliation: Pain Relief Nutrition and Jaundicementioning

confidence: 99%

Pancreatic Cancer: Yesterday, Today and Tomorrow

et al. 2016

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Pancreatic cancer is one of our most lethal malignancies. Despite substantial improvements in the survival rates for other major cancer forms, pancreatic cancer survival rates have remained relatively unchanged since the 1960s. Pancreatic cancer is usually detected at an advanced stage and most treatment regimens are ineffective, contributing to the poor overall prognosis. Herein, we review the current understanding of pancreatic cancer, focusing on central aspects of disease management from radiology, surgery and pathology to oncology. Historical remarks & present stateThe first known description of pancreatic cancer is attributed to Giovanni Battista Morgagni in his 1761 publication 'de Sedibus Et Causis Morborum Per Anatomen Indagatis Libri Quinque' [1]. However, the lack of a microscopic evaluation makes the true diagnosis of ductal adenocarcinoma uncertain. The next important advancement in our understanding of pancreatic cancer did not come until 1858, when Jacob Mendez Da Costa revisited Morgagni's original work and also described the first microscopic diagnosis of adenocarcinoma, manifesting pancreatic cancer as a true disease entity [2].The history of pancreatic surgery is fairly recent and involves a combination of brave surgical pioneers, the development of surgical anesthesia and modern aseptic techniques. Some landmarks in the history of pancreatic surgery deserve to be mentioned. The first reported attempt at a pancreaticoduodenectomy was performed in 1898 by the Italian surgeon Alessandro Codivilla for a tumor involving the head of the pancreas [3]; however, the patient did not survive the postoperative period. In the same year, William Stewart Halsted from Johns Hopkins Hospital performed the first successful resection for ampullary cancer by excising portions of the duodenum and the pancreas [4]. The first successful pancreaticoduodenectomy is credited to the German surgeon Walther Carl Eduard Kausch, as part of a two-stage procedure [5]. In 1914, Georg Hirschel performed the first successful pancreaticoduodenectomy in one stage [6] and then in 1935, Allen Oldfather Whipple presented the results of a two-stage procedure involving the resection of the head of the pancreas and duodenum for ampullary carcinoma at the annual meeting of the American Surgical Association, which renewed interest in pancreatic surgery [7]. During his career, Whipple performed 37 pancreaticoduodenectomies, with the procedure evolving into a one-stage technique [8,9], and 1964-1968 1969-1973 1974-1978 1979-1983 1984-1988 1989-1993 1994-1998 1999-2003 2004-2008 2009-2013 Period of diagnosis Whipple is generally credited with popularizing the operation that still bears his name. In 1937, Alexander Brunschwig performed the first successful pancreaticoduodenectomy for pancreatic adenocarcinoma [10]. Today, with the concentration of experience in high-volume hospitals, pancreatic surgery has become a safe procedure associated with an operative mortality below 3% [11][12][13]. While major advances have been made ...

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“…Another study found that celiac plexus neurolysis caused a signi fi cant but not complete decrease in opioid consumption; patients experienced a mean reduction of 40-80 mg/day of oral morphine [ 4 ] . A multicenter, randomized, control trial of 65 patients [ 39 ] with pancreatic and upper abdominal cancer found no difference in pain relief or opioid consumption between patients who underwent medical management versus celiac plexus neurolysis or thoracic splanchnicectomy.…”

Section: Ef Fi Cacymentioning

confidence: 99%