Initial Evaluation of the Efficacy and Safety of Endoscopic Ultrasound-Guided Direct Ganglia Neurolysis and Block

Levy, Michael J.; Topazian, Mark D.; Wiersema, Maurits J.; Clain, Jonathan E.; Rajan, Elizabeth; Wang, Linghua; Mora, Jose G. De la; Gleeson, Ferga C.; Pearson, Randall K.; Pelaez, Mario; Petersen, Bret T.; Vege, Santhi Swaroop; Chari, Suresh T.

doi:10.1111/j.1572-0241.2007.01607.x

Cited by 229 publications

(148 citation statements)

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“…Successful identification of celiac ganglia during EUS occurred in 81% of patients, with more ganglia identified with linear-array EUS. 108 Levy et al 109 reported 94% complete or partial pain relief in 18 patients with unresectable pancreatic cancer undergoing CGN. Following these promising results, a recent study randomized 68 patients with upper GI cancer pain to undergo either EUS-CPN or EUS-CGN.…”

Section: Eus-guided Anastomosismentioning

confidence: 99%

“…110 Complications from CGN in both studies were minimal and similar to those observed with CPN, including but not limited to diarrhea, hypotension, bleeding at puncture site, and abdominal pain. 3,4,6,109,110 Discussion EUS with FNA remains an exceedingly accurate method in diagnosing and staging pancreatic cancer. However, this accuracy is limited in certain cases, such as chronic pancreatitis.…”

Section: Eus-guided Anastomosismentioning

confidence: 99%

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Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Luthra

Mishra

2017

Int J Gastrointest Interv

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Section: Eus-guided Anastomosismentioning

confidence: 99%

Section: Eus-guided Anastomosismentioning

confidence: 99%

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Luthra

Mishra

2017

Int J Gastrointest Interv

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“…Alcohol injection into ganglia appeared to be effective in both cancer and chronic pancreatitis. 49 Garcia et al in 2009 performed a percutaneous CPN in a 68-yearold male patient using the anterior transgastric route guided by colour Doppler ultrasonography (CDU). Magnetic resonant image (MRI) revealed a large solid mass in the head of the pancreas invading the coeliac trunk and superior mesenteric vessels with diffuse dilatation of the main pancreatic duct.…”

Section: Ultrasound Guidancementioning

confidence: 99%

Coeliac plexus neurolysis for upper abdominal malignancies using an anterior approach: review of the literature

Ghai

Kumar

Wadhera³

2015

Southern African Journal of Anaesthesia and Analgesia

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Background: Coeliac plexus neurolysis (CPN) helps to diminish pain arising from malignancy of upper abdominal viscera. Imaging modalities have increased the success rates by enhancing technical accuracy including fluoroscopy, computed tomography and ultrasound. Advancement in the imaging modalities used has helped in the accurate depiction of anatomy and position of the needle tip. Methods: In an anterior approach, the patient lies supine and the needle is inserted through the anterior abdominal wall into the retropancreatic space. The needle often traverses the stomach, liver or pancreas before reaching the coeliac plexus due to anatomical considerations. The literature has been reviewed regarding various imaging modalities using an anterior approach to coeliac plexus block with regard to success rate, improvement in pain scores, duration of pain relief and analgesic consumption. Results: Successful pain relief in abdominal malignancies with an anterior approach using various imaging modalities varies between 54% and 94% of patients. Following neurolysis, many patients can be weaned off opioids. This procedure improves quality of life and reduces the risk of drug-related side effects. The duration of pain relief after an anterior approach is six to eight weeks. Conclusion: The use of various imaging modalities in an anterior approach has improved the technical accuracy in reaching the coeliac plexus, thereby avoiding the needle piercing crucial structures and avoiding deposition of drug in the retrocrural space, thereby reducing the risk of neurological complications. Coeliac plexus neurolysis via an anterior approach using different imaging modalities does not completely abolish pain, rather it diminishes pain, helping to reduce opioid requirements and improving survival in patients with upper abdominal malignancy.

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“…Moreover, celiac ganglia visualization by EUS in approximately 80 % of cases [9 -12] allows direct injection [13].…”

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confidence: 99%

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2016

Ultraschall in Med

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Initial Evaluation of the Efficacy and Safety of Endoscopic Ultrasound-Guided Direct Ganglia Neurolysis and Block

Abstract: Initial experience suggests that EUS-guided direct celiac ganglion block or neurolysis is safe. Alcohol injection into ganglia appears to be effective in both cancer and chronic pancreatitis. Prospective trials are needed to confirm the efficacy of this new approach.

Cited by 229 publications

References 10 publications

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

Coeliac plexus neurolysis for upper abdominal malignancies using an anterior approach: review of the literature

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