The Pain Alleviation Using Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis in Patients With Unresectable Pancreatic Cancer

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

“…The choice between central and bilateral EUS-CPN remains difficult, depending on the personal skills and experience of the individual endosonographer. We have achieved good results with the central technique, which we consider easier to perform [148].…”

“…To date, only one randomized controlled trial has compared the central and bilateral techniques of EUS-CPN; it found no difference in duration of pain relief (11 vs. 14 weeks), complete pain relief (2/29 vs. 2/21 patients), or reduction in pain medication (9/29 vs. 7/21 patients) [147,148]. The choice between central and bilateral EUS-CPN remains difficult, depending on the personal skills and experience of the individual endosonographer.…”

Pancreatic cancer pain: impact and management challenges

“…Overall, 70%-80% of patients undergoing CPN and BTS report decreased pain for 1-6 months. 1,15,19 Puli et al, Lillemoe et al, and Iwata et al, all, found that bilateral CPN was associated with improved pain control compared with unilateral neurolysis. 1,16,19 This likely holds true despite specific approach.…”

“…They found that EUS-guided CPN significantly decreased pain and improved quality of life. 15 Iwata et al found that, in those patients with favorable characteristics to successful outcomes, early intervention was preferable. 16 Wyse wrote in a randomized control trial of patients undergoing staging EUS early on in the course of their disease that "CPN is currently used late in the disease evolution as a salvage therapy for morphine-resistant pancreatic cancer pain.…”

“…17 Seicean et al reported successful decrease in pain for 75% of patients undergoing CPN at their institution. 15 In a meta-analysis of 21 studies by Eisenberg et al, 89% of patients had pain relief in the initial 2 weeks. Some degree of pain relief continued in nearly 90% of patients at 3 months and 70%-90% of patients until death.…”