EUS-Guided Celiac Plexus Neurolysis for Pain due to Chronic Pancreatitis or Pancreatic Cancer Pain: A Meta-Analysis and Systematic Review

• Published in: Digestive diseases and sciences Vol. 54; no. 11; pp. 2330 - 2337
• Main Authors: Puli, Srinivas R, Reddy, Jyotsna B. K, Bechtold, Matthew L, Antillon, Mainor R, Brugge, William R
• Format: Journal Article
• Language: English
• Published: Boston Boston : Springer US 01-11-2009; Springer US; Springer; Springer Nature B.V
• Subjects: Abdominal Pain - etiology; Abdominal Pain - surgery; Biochemistry; Biological and medical sciences; Celiac Plexus - diagnostic imaging; Celiac Plexus - surgery; Cranial nerves. Peripheral nerves. Autonomic nervous system; Digestive system. Abdomen; Endoscopy; Endosonography; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Gastroenterology; Hepatology; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Medicine; Medicine & Public Health; Nerve Block; Neurosurgery; Oncology; Pancreatic cancer; Pancreatic Neoplasms - complications; Pancreatitis, Chronic - complications; Review; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Transplant Surgery; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Systematic review; Pancreatic cancer; Chronic pancreatitis; Endoscopic ultrasound; Celiac plexus neurolysis; Meta-analysis; Endoscopic route; Review; Pain; Pancreas cancer; Gastroenterology; Endoscopy; Ultrasound; Pancreatic disease; Sonography; Endoscopic ultrasonography; Pancreatitis; Metabolic diseases; Malignant tumor; Neurolysis; Chronic; Echography; Digestive diseases; Bibliographic review; Cancer
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-008-0651-x

The objective of this study was to evaluate the efficacy of EUS-guided CPN for pain relief in patients with chronic pancreatitis and pancreatic cancer. An initial search identified 1,439 reference articles, of which 130 relevant articles were selected and reviewed. Data was extracted from 8 studies (N = 283) for EUS-guided CPN for pain due to pancreatic cancer and nine studies for chronic pancreatitis (N = 376) which met the inclusion criteria. With EUS-guided CPN, the pooled proportion of patients with pancreatic cancer that showed pain relief was 80.12% (95% CI = 74.47-85.22). In patients with pain due to chronic pancreatitis, EUS-guided CPN provided pain relief in 59.45% (95% CI = 54.51-64.30). In conclusion, EUS-guided CPN offers a safe alternative technique for pain relief in patients with chronic pancreatitis or pancreatic cancer. In patients with pain due to chronic pancreatitis, better techniques or injected materials are needed to improve the response.