Moutinho-Ribeiro Pedro, Costa-Moreira Pedro, Caldeira Ana, Leite Sílvia, Marques Susana, Moreira Teresa, Nunes Nuno, Bispo Miguel
Gastroenterology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal.
GE Port J Gastroenterol. 2020 Dec;28(1):32-38. doi: 10.1159/000508293. Epub 2020 Jul 21.
Abdominal pain related to pancreatic disease is often extremely disabling. Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) is used to control pain associated with chronic pancreatitis. EUS-guided celiac plexus neurolysis (CPN) is typically used to reduce pain associated with pancreatic cancer and can be considered early at the time of diagnosis of inoperable disease. EUS-guided celiac plexus interventions have been shown to be significantly effective in pancreatic pain relief, which is achieved in approximately 70-80% of patients with pancreatic cancer and in 50-60% of those with chronic pancreatitis. Serious complications from CPB and CPN are rare. Most frequent adverse events are diarrhoea, orthostatic hypotension, and a transient increase in abdominal pain. In this article, the Portuguese Group for Ultrasound in Gastroenterology (GRUPUGE) presents an updated perspective of the potential role of EUS-guided celiac plexus interventions, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.
与胰腺疾病相关的腹痛常常使人极度丧失活动能力。内镜超声（EUS）引导下的腹腔神经丛阻滞（CPB）用于控制与慢性胰腺炎相关的疼痛。EUS引导下的腹腔神经丛毁损术（CPN）通常用于减轻与胰腺癌相关的疼痛，对于无法手术的疾病，在诊断时即可早期考虑应用。EUS引导下的腹腔神经丛干预已被证明在缓解胰腺疼痛方面显著有效，约70 - 80%的胰腺癌患者以及50 - 60%的慢性胰腺炎患者疼痛得以缓解。CPB和CPN的严重并发症很少见。最常见的不良事件是腹泻、体位性低血压和腹痛短暂加重。在本文中，葡萄牙胃肠病学超声小组（GRUPUGE）对EUS引导下腹腔神经丛干预的潜在作用提出了最新观点，阐述了不同技术的选择标准和技术问题，并分析了其安全性和有效性的最新数据。
