Jonathan M Wyse1, Anand V Sahai2. 1. Division of Gastroenterology, Jewish General Hospital, McGill University, 3755 Cote Ste. Catherine, Montreal, QC, H3W2L2, Canada. jonathan.wyse@mcgill.ca. 2. Division of Gastroenterology, Center Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Abstract
OPINION STATEMENT: PURPOSE OF REVIEW: Unrelenting pain from chronic pancreatitis (CP) and pancreatic cancer (PC) remain clinical challenges for the physician and a significant cause of decreased quality of life for the patient. Endoscopic ultrasound (EUS)-guided therapy for each condition is distinct and builds on the endosonographer's straightforward access to the celiac axis. RECENT FINDINGS: Over the past 20 years, generally small studies of modest methodology have surfaced for both EUS-guided celiac plexus block (CPB) and celiac plexus neurolysis (CPN). Our review aims to synthesize, analyze, and update the latest literature on the technique, efficacy, and safety of these procedures. EUS-CPB's role in treating CP pain is likely still relevant for a subset of patients and studies have shown efficacy and safety. However, a dramatic drop in research publications on the topic will make optimizing its role (including technique, injectate, and patient selection) increasingly difficult. However, EUS-CPN for PC pain is actively being refined with new information, data, and even guidelines. New EUS-guided strategies to treat PC pain besides conventional neurolysis are also likely to evolve in coming years.
OPINION STATEMENT: PURPOSE OF REVIEW: Unrelenting pain from chronic pancreatitis (CP) and pancreatic cancer (PC) remain clinical challenges for the physician and a significant cause of decreased quality of life for the patient. Endoscopic ultrasound (EUS)-guided therapy for each condition is distinct and builds on the endosonographer's straightforward access to the celiac axis. RECENT FINDINGS: Over the past 20 years, generally small studies of modest methodology have surfaced for both EUS-guided celiac plexus block (CPB) and celiac plexus neurolysis (CPN). Our review aims to synthesize, analyze, and update the latest literature on the technique, efficacy, and safety of these procedures. EUS-CPB's role in treating CP pain is likely still relevant for a subset of patients and studies have shown efficacy and safety. However, a dramatic drop in research publications on the topic will make optimizing its role (including technique, injectate, and patient selection) increasingly difficult. However, EUS-CPN for PC pain is actively being refined with new information, data, and even guidelines. New EUS-guided strategies to treat PC pain besides conventional neurolysis are also likely to evolve in coming years.
Authors: P Fusaroli; C Jenssen; M Hocke; E Burmester; E Buscarini; R F Havre; A Ignee; A Saftoiu; P Vilmann; C P Nolsøe; D Nürnberg; M D'Onofrio; O H Gilja; T Lorentzen; F Piscaglia; P S Sidhu; C F Dietrich Journal: Ultraschall Med Date: 2015-12-03 Impact factor: 6.548
Authors: Srinivas R Puli; Jyotsna B K Reddy; Matthew L Bechtold; Mainor R Antillon; William R Brugge Journal: Dig Dis Sci Date: 2009-01-10 Impact factor: 3.199
Authors: Jonathan M Wyse; Robert Battat; Siyu Sun; Adrian Saftoiu; Ali A Siddiqui; Ang Tiing Leong; Brenda Lucia Arturo Arias; Carlo Fabbri; Douglas G Adler; Erwin Santo; Evangelos Kalaitzakis; Everson Artifon; Girish Mishra; Hussein Hassan Okasha; Jan Werner Poley; Jintao Guo; Juan J Vila; Linda S Lee; Malay Sharma; Manoop S Bhutani; Marc Giovannini; Masayuki Kitano; Mohamad Ali Eloubeidi; Mouen A Khashab; Nam Q Nguyen; Payal Saxena; Peter Vilmann; Pietro Fusaroli; Pramod Kumar Garg; Sammy Ho; Shuntaro Mukai; Silvia Carrara; Subbaramiah Sridhar; Sundeep Lakhtakia; Surinder S Rana; Vinay Dhir; Anand V Sahai Journal: Endosc Ultrasound Date: 2017 Nov-Dec Impact factor: 5.628
Authors: E Martin-Perez; J E Domínguez-Muñoz; F Botella-Romero; L Cerezo; F Matute Teresa; T Serrano; R Vera Journal: Clin Transl Oncol Date: 2020-04-21 Impact factor: 3.405
Authors: István Molnár; Gabriella Hegyi; Lajos Zsom; Christine Saahs; Jan Vagedes; Gábor Kapócs; Zoltán Kovács; Martin-Günther Sterner; Henrik Szőke Journal: J Pain Res Date: 2019-01-14 Impact factor: 3.133