Thoracoscopic Splanchnicectomy for Pain Relief in Unresectable Pancreatic Cancer

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

“…There was information about the percentage with effective pain relief at 2 weeks but not 2 months. Our initial sample size calculation was therefore based on the observations that opioid treatment had achieved good pain relief in the first 2 weeks in an estimated 70% of patients [1], and CPB or TS gives good pain relief immediately in 90% of patients [14,16]. A Bonferroni correction was included for 3 pairwise comparisons (α = 0.016).…”

Metastatic Pancreatic Cancer: Emerging Strategies in Chemotherapy and Palliative Care

“…This offers fast and effective pain control for a duration of 3 to 4 months in 80%-90% of patients [12]. Celiac block was described more than 80 years ago by Kappis and can be performed percutaneously (under radiologic guidance) or intraoperatively [5,8,10,[12][13][14].…”

“…The effect of celiac plexus neurolysis is unfortunately not permanent, and severe pain can return after a variable period. Chemical splanchnicectomy or celiac axis block can then be repeated using numerous techniques (computerized tomography guided, magnetic resonance imaging guided, endoscopic ultrasound guided, or laparoscopically) [13,[15][16][17][18].…”

Pancreatic cancer pain: impact and management challenges

“…They based this on the fact that their study demonstrated significant reduction in pain and improvement in quality of life. 17 Finally, in a meta-analysis, Eisenberg et al wrote that…”

“…21 In a prospective nonrandomized trial, Pietrabissa et al showed pain relief and improved quality of life at 3 months postintervention in all 24 patients enrolled in the study. 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.…”