Eus-guided celiac plexus interventions in pancreatic cancer pain: An update and controversies for the endosonographer

Leticia Perondi Luz, Mohammad Ali Al-Haddad, John A. De Witt

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Patients with pancreatic cancer (pancreatic ductal adenocarcinoma [PDAC]) can develop abdominal pain that can be debilitating. Celiac plexus neurolysis (CPN) is a chemical ablation of the celiac plexus that can be used to treat pain caused by pancreatic malignancy. It can be performed by an anterior or posterior approach, and also can be done percutaneously or under guidance of transabdominal ultrasound, computed tomography, intra-operatively or most recently under linear endoscopic ultrasound (EUS) guidance (EUS-CPN). EUS is well-suited for identifi cation of the celiac plexus due to the close proximity of the gastric wall to the origin of the celiac artery. EUS-CPN is now widely practiced, and different EUS approaches have been developed in order to improve the efficacy of this technique. Our objective is to review the use of EUS-CPN in PDAC, including a description of different techniques, review of its efficacy, predictors of pain response, and describe its limitations and safety, as well as new developments.

Original languageEnglish (US)
Pages (from-to)213-220
Number of pages8
JournalEndoscopic Ultrasound
Volume3
Issue number4
DOIs
StatePublished - Jan 1 2014

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Keywords

  • Celiac plexus neurolysis
  • Endoscopic ultrasound
  • Pancreatic cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Hepatology

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