Endoscopic ultrasound in pancreatic cancer treatment: Facts and hopes

Moutinho-Ribeiro, Pedro; Liberal, Rodrigo; Macedo, Guilherme

doi:10.1016/j.clinre.2019.02.014

Cited by 7 publications

(9 citation statements)

References 78 publications

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“…CPB is indicated for management of pain associated with chronic pancreatitis. CPN is mostly indicated in patients with pancreatic cancer [4]. A recent consensus statement recommends against EUS-CPN for the treatment of chronic pancreatitis pain [8].…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

“…Two approaches are currently used when performing EUS-CPN [4]. The classic approach, known as the central technique, involves injection of the agent at the base of the CA.…”

Section: Procedural Descriptionmentioning

confidence: 99%

“…Therefore, palliative pain control is crucial in the context of advanced pancreatic cancer [3, 4]. Non-narcotic medical therapies are often inadequate, and opioids commonly induce nausea, constipation, and other side effects [5].…”

Section: Introductionmentioning

confidence: 99%

“…Non-narcotic medical therapies are often inadequate, and opioids commonly induce nausea, constipation, and other side effects [5]. If patients have refractory pain or cannot tolerate increasing amounts of opioid medications, endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) and neurolysis (CPN) may play an important role [4]. CPB is a temporary treatment and most commonly refers to the injection of a steroid and a long-acting local anaesthetic into the celiac plexus.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Ultrasound-Guided Celiac Plexus Interventions

Moutinho-Ribeiro

Costa-Moreira

Caldeira³

et al. 2020

GE Port J Gastroenterol

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Abdominal pain related to pancreatic disease is often extremely disabling. Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) is used to control pain associated with chronic pancreatitis. EUS-guided celiac plexus neurolysis (CPN) is typically used to reduce pain associated with pancreatic cancer and can be considered early at the time of diagnosis of inoperable disease. EUS-guided celiac plexus interventions have been shown to be significantly effective in pancreatic pain relief, which is achieved in approximately 70–80% of patients with pancreatic cancer and in 50–60% of those with chronic pancreatitis. Serious complications from CPB and CPN are rare. Most frequent adverse events are diarrhoea, orthostatic hypotension, and a transient increase in abdominal pain. In this article, the Portuguese Group for Ultrasound in Gastroenterology (GRUPUGE) presents an updated perspective of the potential role of EUS-guided celiac plexus interventions, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.

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Section: Indications and Contraindicationsmentioning

confidence: 99%

“…Two approaches are currently used when performing EUS-CPN [4]. The classic approach, known as the central technique, involves injection of the agent at the base of the CA.…”

Section: Procedural Descriptionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic Ultrasound-Guided Celiac Plexus Interventions

Moutinho-Ribeiro

Costa-Moreira

Caldeira³

et al. 2020

GE Port J Gastroenterol

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“…The most encouraging EUS-guided ablation outcomes are being reached in the treatment of some pancreatic cystic neoplasms and small (≤2 cm) pNETs [6-8]. Data supporting a potential role of ablative therapies in the treatment of pancreatic ductal adenocarcinoma is still lacking [9].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Ablation of Focal Pancreatic Lesions: The GRUPUGE Perspective

Bispo

Caldeira²,

Leite

et al. 2020

GE Port J Gastroenterol

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Focal pancreatic lesions include a heterogeneous group of solid and cystic lesions, with different natures and variable clinical, imagiological, and pathological characteristics. Several endoscopic ultrasound (EUS)-guided ablative techniques have been tested during the last decade for the treatment of these pancreatic lesions, mostly consisting of the injection of ablative agents and, more recently, radiofrequency ablation. The most encouraging EUS-guided ablation outcomes are being reached in the treatment of some pancreatic cystic neoplasms and small (≤2 cm) pancreatic neuroendocrine tumours (pNETs). Data supporting a potential role of ablative therapies in the treatment of pancreatic ductal adenocarcinoma is still lacking. In this article, GRUPUGE presents an updated perspective of the potential role of EUS-guided ablation for the treatment of pancreatic cystic neoplasms and pNETs, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.

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