EUS-guided celiac plexus neurolysis for pancreas cancer – Finally established or still under review?

Elsevier

Available online 22 November 2022, 101809

Best Practice & Research Clinical GastroenterologyAuthor links open overlay panelAbstract

Patients with pancreas cancer must deal frequently with intractable and refractory pain. Endoscopic ultrasound guided-celiac plexus neurolysis (EUS-CPN) has been the most studied and used therapeutic technique aimed to destroy the pain fibres that allow the pancreas to communicate with the central nervous system. A neurolytic agent, most commonly ethanol, is optimally spread around the celiac axis in order to reduce pain and mitigate narcotic requirements. This can be performed early to prevent the spiral of pain and medication use, or more historically as salvage therapy. Different techniques to best administer the ethanol for effective EUS-CPN are still being debated. New EUS-guided injection techniques with radiofrequency, radioactive, and/or chemotherapeutic agents need more study.

Keywords

Pancreas cancer

Pain

Celiac plexus

Neurolysis

Endoscopic ultrasound

Ganglia

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© 2022 Published by Elsevier Ltd.

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