Celiac Plexus Block and Neurolysis for Pancreatic Cancer

  title={Celiac Plexus Block and Neurolysis for Pancreatic Cancer},
  author={Bret M Bahn and Michael A. Erdek},
  journal={Current Pain and Headache Reports},
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. 
Celiac Plexus Blocks and Splanchnic Nerve Blocks
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.
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
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.
Celiac Plexus Block in the Management of Chronic Abdominal Pain
A review is presented describing the indications, technical aspects, and agents utilized to block the celiac plexus in patients suffering from chronic abdominal pain.
Symptoms of Impending Gallbladder Perforation and Acute Cholecystitis in a Pancreatic Cancer Patient Masked by Celiac Plexus Block
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.
A Comprehensive Review of the Celiac Plexus Block for the Management of Chronic Abdominal Pain
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
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
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
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.


The Effectiveness of Repeat Celiac Plexus Neurolysis for Pancreatic Cancer: A Pilot Study
The objective of this study is to determine the success rate and duration of relief following repeat celiac plexus neurolysis (rCPN) for PCP.
Diagnostic celiac plexus block and outcome with neurolysis
The techniques for chemical neurolysis of the celiac plexus are reviewed, the literature supporting the different approaches are discussed, and factors that may influence the decision to proceed with diagnostic block prior to the neurolytic procedure are discussed.
Efficacy of Neurolytic Celiac Plexus Block in Varying Locations of Pancreatic Cancer: Influence on Pain Relief
Unilateral transcrural celiac plexus neurolysis has been shown to provide effective pain relief in 74% of patients with pancreatic cancer pain, depending on the location of the pancreatic tumor.
Neurolytic Celiac Plexus Block for Treatment of Cancer Pain: A Meta-Analysis
A meta-analysis of the efficacy and safety of neurolytic celiac plexus block (NCPB) for cancer pain suggests that NCPB has long-lasting benefit for 70%-90% of patients with pancreatic and other intraabdominal cancers, regardless of the technique used.
Celiac Plexus Block
In 1919 Kappis [1] described percutaneous celiac plexus block. Since then, variations and refinements in his technique have been proposed, including the use of roentgenographic techniques to improve
Endosonography-guided celiac plexus neurolysis.
Assessment of celiac plexus block and neurolysis outcomes and technique in the management of refractory visceral cancer pain.
Celiac plexus neurolysis may provide intermediate pain relief to a significant percentage of cancer sufferers and both careful selection of candidates based on clinical variables, and technical factors aimed at enhancing the specificity of blocks may lead to improved outcomes.
Celiac plexus block: efficacy and safety of the anterior approach.
The anterior approach to a celiac plexus block performed via an anterior approach is a safe and effective means of pain control in patients with pancreatic carcinoma and should be considered for all patients with pain caused by pancreatic cancer that is refractory to pain medication.
Management of Chronic Upper Abdominal Pain in Cancer: Transdiscal Blockade of the Splanchnic Nerves
Splanchnic nerve blockade via a transdiscal approach is a technique that provides analgesia and the alleviation of the secondary undesirable effects of analgesic drugs resulting from the decrease of morphine consumption in patients with upper abdominal malignancies.