A Comparison of Ultrasound and Fluoroscopy- Guided Celiac Plexus Neurolysis in Patients With Pancreatic Cancer

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

Journal Name: Current Cancer Therapy Reviews

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

Patients and methods: This study included 60 patients presenting with pancreatic cancer pain; who were subjected to one session of celiac plexus neurolysisand 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 neurolysisis more durable, tolerable, effective and safe compared to fluoroscopy guided neurolysisof patient suffering from pancreatic cancer pain.

Keywords: Celiac plexus neurolysis, Pain, Management, Visual analogue score, Analgesia, Cancer.

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(E-pub Ahead of Print)
DOI: 10.2174/1573394715666190904091145