Abstract
Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is an endoscopic procedure performed to manage the debilitating and refractory chronic pain caused by pancreatic cancer [1] and chronic pancreatitis [2]. Although CPN could be performed percutaneously under ultrasound or computed tomography (CT) guidance [3], EUS has the advantage of easily identifying and getting in close proximity to the celiac plexus, which enhances needle localization and the spread of the injected material and potentially minimizes adverse events and improves pain response [4]. Under EUS guidance, the celiac plexus is injected with a mixture of bupivacaine (0.25%) and dehydrated alcohol (99%) for neurolysis. When EUS-CPN is used for chronic pancreatitis, alcohol is substituted by steroid (Triamcinolone 80 mg) for what is referred to as celiac plexus block.
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References
Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290–5.
Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–34.
Wang PJ, Shang MY, Qian Z, et al. CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging. 2006;31:710–8.
Gress F, Schmitt C, Sherman S, et al. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94:900–5.
Puli SR, Reddy JB, Bechtold ML, et al. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci. 2009;54:2330–7.
Wyse JM, Carone M, Paquin SC, et al. Randomized, double-blind, controlled trial of early endoscopic ultrasound-guided celiac plexus neurolysis to prevent pain progression in patients with newly diagnosed, painful, inoperable pancreatic cancer. J Clin Oncol. 2011;29:3541–6.
Levy M, Rajan E, Keeney G, et al. Neural ganglia visualized by endoscopic ultrasound. Am J Gastroenterol. 2006;101:1787–91.
Levy MJ, Topazian MD, Wiersema MJ, et al. Initial evaluation of the efficacy and safety of endoscopic ultrasound-guided direct ganglia neurolysis and block. Am J Gastroenterol. 2008;103:98–103.
Wyse JM, Battat R, Sun S, et al. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis. Endosc Ultrasound. 2017;6:369–75.
Mulhall AM, Rashkin MC, Pina EM. Bilateral diaphragmatic paralysis: a rare complication related to endoscopic ultrasound-guided celiac plexus neurolysis. Ann Am Thorac Soc. 2016;13:1660–2.
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Marya, N., Sawas, T., Levy, M.J. (2022). EUS-Guided Celiac Plexus Neurolysis. In: Teoh, A.Y., Giovaninni, M., Khashab, M.A., Itoi, T. (eds) Atlas of Interventional EUS. Springer, Singapore. https://doi.org/10.1007/978-981-16-9340-3_20
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DOI: https://doi.org/10.1007/978-981-16-9340-3_20
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