Computed tomography-guided percutaneous neurolysis of celiac plexus: technical description

Abstract

through chemical ablation, potentially improving pain control while dramatically reducing opioid consumption (9,10). It involves the infusion of a neurolytic agent, typically sterile absolute alcohol, through a fine needle inserted into the retroperitoneum, adjacent to nerve fibers and the ganglia of the celiac plexus. The neurolytic agent disrupts the neural network, interrupting the pain pathways (2,11). Imaging guidance for CPN is most often performed by computed tomography (CT), which has replaced fluoroscopy and ultrasound for that purpose (2,12). PROCEDURE The first step in CT-guided NPC is pre-procedure planning. Preoperative images should be reviewed in detail to determine the positioning of the patient, as well as to select the puncture site, needle path, and neurolytic injection site (Figure 1B). The pre-procedure planning ensures that the agent is properly distributed, increases the analgesic effect, and reduces morbidity. Proper patient positioning is essential for a successful procedure, because it

The Neuroimmune Axis and Its Therapeutic Potential for Primary Liver Cancer

“…The results demonstrated that celiac plexus neurolysis was highly effective for achieving substantial pain relief in these patients [ 93 ]. Patients should be offered it as part of a multidisciplinary approach to managing severe, persistent abdominal pain [ 94 ].…”