Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis
The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2018-02-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | http://www.mdpi.com/2072-6694/10/2/50 |
| _version_ | 1797715714949251072 |
|---|---|
| author | Kosuke Minaga Mamoru Takenaka Ken Kamata Tomoe Yoshikawa Atsushi Nakai Shunsuke Omoto Takeshi Miyata Kentaro Yamao Hajime Imai Hiroki Sakamoto Masayuki Kitano Masatoshi Kudo |
| author_facet | Kosuke Minaga Mamoru Takenaka Ken Kamata Tomoe Yoshikawa Atsushi Nakai Shunsuke Omoto Takeshi Miyata Kentaro Yamao Hajime Imai Hiroki Sakamoto Masayuki Kitano Masatoshi Kudo |
| author_sort | Kosuke Minaga |
| collection | DOAJ |
| description | The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation. |
| first_indexed | 2024-03-12T08:10:47Z |
| format | Article |
| id | doaj.art-71e59400d81e41d3aeea58ca7bc5fa35 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T08:10:47Z |
| publishDate | 2018-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-71e59400d81e41d3aeea58ca7bc5fa352023-09-02T19:08:20ZengMDPI AGCancers2072-66942018-02-011025010.3390/cancers10020050cancers10020050Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided NeurolysisKosuke Minaga0Mamoru Takenaka1Ken Kamata2Tomoe Yoshikawa3Atsushi Nakai4Shunsuke Omoto5Takeshi Miyata6Kentaro Yamao7Hajime Imai8Hiroki Sakamoto9Masayuki Kitano10Masatoshi Kudo11Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanDepartment of Gastroenterology, Katsuragi Hospital, Kishiwada 596-0825, JapanSecond Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, JapanDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, JapanThe most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation.http://www.mdpi.com/2072-6694/10/2/50endoscopic ultrasoundEUSEUS-guided neurolysisneurolysisinterventional EUSpancreatic cancerpain |
| spellingShingle | Kosuke Minaga Mamoru Takenaka Ken Kamata Tomoe Yoshikawa Atsushi Nakai Shunsuke Omoto Takeshi Miyata Kentaro Yamao Hajime Imai Hiroki Sakamoto Masayuki Kitano Masatoshi Kudo Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis Cancers endoscopic ultrasound EUS EUS-guided neurolysis neurolysis interventional EUS pancreatic cancer pain |
| title | Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis |
| title_full | Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis |
| title_fullStr | Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis |
| title_full_unstemmed | Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis |
| title_short | Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis |
| title_sort | alleviating pancreatic cancer associated pain using endoscopic ultrasound guided neurolysis |
| topic | endoscopic ultrasound EUS EUS-guided neurolysis neurolysis interventional EUS pancreatic cancer pain |
| url | http://www.mdpi.com/2072-6694/10/2/50 |
| work_keys_str_mv | AT kosukeminaga alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT mamorutakenaka alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT kenkamata alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT tomoeyoshikawa alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT atsushinakai alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT shunsukeomoto alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT takeshimiyata alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT kentaroyamao alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT hajimeimai alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT hirokisakamoto alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT masayukikitano alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis AT masatoshikudo alleviatingpancreaticcancerassociatedpainusingendoscopicultrasoundguidedneurolysis |