Department of Endoscopy, Ministry of Internal Affairs Hospital, Ul. Jagielonska 44, 70-362 Szczecin, Poland.
Gastroenterol Res Pract. 2012;2012:503098. doi: 10.1155/2012/503098. Epub 2012 Feb 7.
Introduction. Celiac plexus neurolysis is used in pain management of patients with advanced and unresectable pancreatic cancer. We retrospectively analyzed efficacy and safety of endoscopic ultrasound- (EUS-) guided celiac plexus neurolysis in patients treated in our unit. Methods. Twenty nine subjects with unresectable pancreatic cancer and severe pain despite pharmacological treatment underwent EUS-guided celiac plexus neurolysis with 98% ethanol. Patients scored their pain according to a 0-10 point scale and were interviewed 1-2 weeks and 2-3 months after the procedure. Results. Twenty five (86%) patients reported improvement in their pain at 1-2 weeks following the procedure. Of these, 7 (24%) reported substantial improvement (decrease in pain by more than 50%) and 4 (14%) complete disappearance of pain. Pain relief was still present in 76% of patients after 2-3 months. Treatment-related side effects included hypotonia in 1 patient, severe pain immediately postprocedure in 2 patients, and short episodes of diarrhea in 3 patients. Conclusion. Endoscopic ultrasound- (EUS-) guided celiac plexus neurolysis is a safe and effective treatment of severe pain from advanced pancreatic cancer.
介绍。腹腔神经丛松解术用于治疗晚期不可切除胰腺癌患者的疼痛管理。我们回顾性分析了在我科治疗的患者中，超声内镜（EUS）引导下腹腔神经丛松解术的疗效和安全性。
方法。29 例不可切除胰腺癌且药物治疗后仍有严重疼痛的患者接受了 98%乙醇的 EUS 引导下腹腔神经丛松解术。患者根据 0-10 分的评分标准对疼痛进行评分，并在术后 1-2 周和 2-3 个月进行访谈。
结果。25 例（86%）患者在术后 1-2 周报告疼痛有所改善。其中，7 例（24%）报告明显改善（疼痛减轻超过 50%），4 例（14%）完全消失疼痛。2-3 个月后，76%的患者仍有疼痛缓解。与治疗相关的副作用包括 1 例患者出现低血压，2 例患者术后立即出现严重疼痛，3 例患者出现短暂腹泻。
结论。超声内镜（EUS）引导下腹腔神经丛松解术是治疗晚期胰腺癌严重疼痛的一种安全有效的方法。
