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Current Cancer Therapy Reviews

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ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

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General Research Article

A Comparison of Ultrasound and Fluoroscopy-guided Celiac Plexus Neurolysis in Patients with Pancreatic Cancer

Author(s): Khadeja M. Elhossieny*, Waseem M. Seleem, Sherief Abd-Elsalam, Tamer Haydara and Nashwa Mohamed El Gharbawy

Volume 16, Issue 3, 2020

Page: [246 - 252] Pages: 7

DOI: 10.2174/1573394715666190904091145

Abstract

Background & Aims: Celiac plexus neurolysis is an elegant way of reducing pain in patients with pancreatic cancer. The aim of this work was to compare the effectiveness of ultrasound versus fluoroscopy-guided celiac plexus neurolysis in pancreatic cancer management.

Methods: This study included 60 patients presenting with pancreatic cancer pain; who were subjected to one session of celiac plexus neurolysis and were divided equally into two groups: - Group (1): included 30 patients (12 females&18 males); who were exposed to ultrasound (US)- guided celiac plexus neurolysis and group (2): included 30 patients (10 females & 20 males) who were exposed to fluoroscopy-guided celiac plexus neurolysis. Abdominal pain was assisted by visual analogue score (VAS).

Results: Regarding VAS, our results revealed that all patients showed improvement after celiac plexus neurolysis either through ultrasound technique or via percutaneous fluoroscopy technique. Furthermore, the ultrasound group recorded more significant pain relief with improved VAS than the fluoroscopy group immediately and on long-term follow-up with mean ± SD as follows: - Immediately (9.2 ± 0.8) to (2.5 ± 0.7) vs. (9.1 ± 0.7) to (3.5 ± 0.82, respectively); After 1 week (1.1 ± 0.8 vs. 3.6 ± 1.7, respectively), after 1 month ( 1 ± 0.9 vs. 3.7 ± 1.9), after three months (1.7 ± 1.01 vs. 5.9 ± 1.7, respectively) and after 6 months (2.3 ± 0.6 vs. 7.5 ± 1.6, respectively).

Conclusion: The study revealed that ultrasound-guided celiac plexus neurolysis is more durable, tolerable, effective and safe compared to fluoroscopy-guided neurolysis of patient suffering from pancreatic cancer pain.

Keywords: Celiac plexus neurolysis, pain, management, visual analogue score, analgesia, pancreatic cancer, ultrasoundguided, fluoroscopy-guided.

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[1]
Paulson AS, Tran Cao HS, Tempero MA, Lowy AM. Therapeutic advances in pancreatic cancer. Gastroenterology 2013; 144(6): 1316-26.
[http://dx.doi.org/10.1053/j.gastro.2013.01.078.] [PMID: 23622141.]
[2]
Nienhuijs SW, van den Akker SA, de Vries E, de Hingh IH, Visser O, Lemmens VE. Nationwide improvement of only short-term survival after resection for pancreatic cancer in the Netherlands. Pancreas 2012; 41(7): 1063-6.
[http://dx.doi.org/10.1097/MPA.0b013e31824c3dbf.] [PMID: 22617713.]
[3]
Bosetti C, Bertuccio P, Malvezzi M, et al. Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980. Ann Oncol 2013; 24(10): 2657-71.
[http://dx.doi.org/10.1093/annonc/mdt301.] [PMID: 23921790.]
[4]
Ziada DH, El Sadany S, Soliman H, et al. Prevalence of hepatocellular carcinoma in chronic hepatitis C patients in Mid Delta, Egypt: A single center study. J Egypt Natl Canc Inst 2016; 28(4): 257-62.
[http://dx.doi.org/10.1016/j.jnci.2016.06.001.] [PMID: 27378258.]
[5]
Abdelfattah AAM, Rizk F, Hawash N, Hanafy A, El-Kalla F, Abd-Elsalam S. Randomized trial of preoperative administration of oral pregabalin for postoperative analgesia in patients scheduled for radiofrequency ablation of focal lesions in the liver. Int J Hyperthermia 2018; 34(8): 1367-71.
[http://dx.doi.org/10.1080/02656736.2018.1424946.] [PMID: 29308685.]
[6]
Seicean A. Celiac plexus neurolysis in pancreatic cancer: the endoscopic ultrasound approach. World J Gastroenterol 2014; 20(1): 110-7.
[http://dx.doi.org/10.3748/wjg.v20.i1.110.] [PMID: 24415863.]
[7]
Kambadakone A, Thabet A, Gervais DA, Mueller PR, Arellano RS. CT-guided celiac plexus neurolysis: A review of anatomy, indications, technique, and tips for successful treatment. Radiographics 2011; 31(6): 1599-621.
[http://dx.doi.org/10.1148/rg.316115526.] [PMID: 21997984.]
[8]
Wong GY, Schroeder DR, Carns PE, et al. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA 2004; 291(9): 1092-9.
[http://dx.doi.org/10.1001/jama.291.9.1092.] [PMID: 14996778.]
[9]
Ghai A, Kumar H, Karwasra RK. Ultrasound guided celiac plexus neurolysis by anterior approach for pain management in upper abdominal malignancy: Our experience. Anaesth Pain Intensive Care 2015; 19(3): 274-81.
[10]
Miguel R. Interventional treatment of cancer pain: the fourth step in the World Health Organization analgesic ladder? Cancer Contr 2000; 7(2): 149-56.
[http://dx.doi.org/10.1177/107327480000700205.] [PMID: 10783819.]
[11]
Staats PS, Hekmat H, Sauter P, Lillemoe K. The effects of alcohol celiac plexus block, pain, and mood on longevity in patients with unresectable pancreatic cancer: A double-blind, randomized, placebo-controlled study. Pain Med 2001; 2(1): 28-34.
[http://dx.doi.org/10.1046/j.1526-4637.2001.002001028.x.] [PMID: 15102315.]
[12]
Santosh D, Lakhtakia S, Gupta R, et al. Clinical trial: a randomized trial comparing fluoroscopy guided percutaneous technique vs. endoscopic ultrasound guided technique of coeliac plexus block for treatment of pain in chronic pancreatitis. Aliment Pharmacol Ther 2009; 29(9): 979-84.
[http://dx.doi.org/10.1111/j.1365-2036.2009.03963.x.] [PMID: 19222416.]
[13]
Giménez A, Martínez-Noguera A, Donoso L, Catalá E, Serra R. Percutaneous neurolysis of the celiac plexus via the anterior approach with sonographic guidance. AJR Am J Roentgenol 1993; 161(5): 1061-3.
[http://dx.doi.org/10.2214/ajr.161.5.8273610.] [PMID: 8273610.]
[14]
Wang PJ, Shang MY, Qian Z, Shao CW, Wang JH, Zhao XH. CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging 2006; 31(6): 710-8.
[http://dx.doi.org/10.1007/s00261-006-9153-5.] [PMID: 17151902.]
[15]
Akhan O, Ozmen MN, Basgun N, et al. Long-term results of celiac Ganglia block: correlation of grade of tumoral invasion and pain relief. AJR Am J Roentgenol 2004; 182(4): 891-6.
[http://dx.doi.org/10.2214/ajr.182.4.1820891.] [PMID: 15039160.]
[16]
Gunaratnam NT, Sarma AV, Norton ID, Wiersema MJ. A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain. Gastrointest Endosc 2001; 54(3): 316-24.
[http://dx.doi.org/10.1067/mge.2001.117515.] [PMID: 11522971.]
[17]
Narouze S, Gruber H. Ultrasound-guided celiac plexus block and neurolysis. In: Atlas of ultrasound-guided procedures in interventional pain management. 2011; pp. 199-206.
[http://dx.doi.org/10.1007/978-1-4419-1681-5_15]
[18]
Bhatnagar S, Gupta D, Mishra S, Thulkar S, Chauhan H. Bedside ultrasound-guided celiac plexus neurolysis with bilateral paramedian needle entry technique can be an effective pain control technique in advanced upper abdominal cancer pain. J Palliat Med 2008; 11(9): 1195-9.
[http://dx.doi.org/10.1089/jpm.2008.0082.] [PMID: 19021480.]
[19]
Sheta E, El-Kalla F, El-Gharib M, et al. Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: A randomized-controlled study. Eur J Gastroenterol Hepatol 2016; 28(10): 1198-203.
[http://dx.doi.org/10.1097/MEG.0000000000000688.] [PMID: 27362551.]
[20]
Negm O, Abou Saif S, El Gharib M, Yousef M, Abd-Elsalam S. Role of low-molecular-weight heparins in prevention of thromboembolic complication after transarterial chemoembolization in hepatocellular carcinoma. Eur J Gastroenterol Hepatol 2017; 29(3): 317-21.
[http://dx.doi.org/10.1097/MEG.0000000000000790.] [PMID: 27893491.]
[21]
Elwan N, Salem ML, Kobtan A, et al. High numbers of myeloid derived suppressor cells in peripheral blood and ascitic fluid of cirrhotic and HCC patients. Immunol Invest 2018; 47(2): 169-80.
[http://dx.doi.org/10.1080/08820139.2017.1407787.] [PMID: 29182438.]
[22]
Mansour L, El-Kalla F, El-Bassat H, et al. Randomized controlled trial of scleroligation versus band ligation alone for eradication of gastroesophageal varices. Gastrointest Endosc 2017; 86(2): 307-15.
[http://dx.doi.org/10.1016/j.gie.2016.12.026.] [PMID: 28082116.]
[23]
Tadros MY, Elia RZ. Percutaneous ultrasound-guided celiac plexus neurolysis in advanced upper abdominal cancer pain. Egyptian J Radiol Nuclear Med 2015; 46: 993-8.

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