Celiac Plexus Block and Neurolysis for Pancreatic Cancer

@article{Bahn2013CeliacPB,
  title={Celiac Plexus Block and Neurolysis for Pancreatic Cancer},
  author={Bret M Bahn and Michael A. Erdek},
  journal={Current Pain and Headache Reports},
  year={2013},
  volume={17},
  pages={1-7}
}
Neurolytic celiac plexus blocks (NCPB) have been performed for many years for the treatment of cancer and some non-cancer pain conditions associated with the upper gastrointestinal tract. The block can provide adequate pain relief from the area of the distal esophagus to the transverse colon, and can be approached from a variety of ways. This is a review of the anatomy, patient selection, technique, medications used, possible complications, and efficacy of the treatment. 
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Though performing this block has been described with and without various forms of imaging, two mainstream techniques using fluoroscopic guidance, transcrural and retrocrural, are discussed and explained in detail.
Celiac Plexus Block and Neurolysis in the Management of Chronic Upper Abdominal Pain.
TLDR
Celiac plexus block and neurolysis are safe and effective treatments for chronic upper abdominal pain and should be considered early in patients experiencing such symptoms.
Autonomic insufficiency after neurolytic celiac plexus block
TLDR
The most common side effects of celiac plexus blockade and neurolysis are transient hypotension, possibly from inhibition of splanchnic vasoconstriction and/or spread of injectate to thoracic sympathetic nerves, and transient diarrhea, from increased peristalsis.
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TLDR
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TLDR
A case of a patient with advanced pancreatic cancer who had undergone two separate CPB procedures who subsequently developed acute cholecystitis is described, highlighted by the relative benign presentation of the patient including an absent Murphy's sign and normal liver function serum profile.
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TLDR
A comprehensive review of the CPB as it pertains to CAP is provided with a focus on the associated anatomy, indications, techniques, neurolysis/blocking agents, and complications observed in patients who undergo CPB for the treatment of CAP.
CT guided neurolytic blockade of the coeliac plexus in patients with advanced and intractably painful pancreatic cancer
TLDR
CT guided neurolytic celiac plexus blockade is a safe and effective treatment for intractable pain caused by advanced pancreatic cancer and should be offered patients experiencing intractably cancer related pain.
Predictors of analgesic efficacy of neurolytic celiac plexus block in patients with unresectable pancreatic cancer: the importance of timing
TLDR
NCPB should be offered early to selected patients to improve its analgesic efficacy in advance of deterioration from disease and pain in this population of patients with unresectable pancreatic cancer.
Interventional Treatments for Cancer Pain.
Interventional pain management is a subspecialty of medicine devoted to the use of invasive techniques such as joint injections, nerve blocks/or neurolysis, neuromodulation, and epidural and
Factors associated with successful response to neurolytic celiac plexus block in patients with upper abdominal cancer-related pain: a retrospective study
TLDR
Celiac plexus metastases, absence of diabetes, and absence of prior upper abdominal surgery may be independently associated with better response to NCPB for upper abdominal cancer-related pain.
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