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Cancers 2018, 10(2), 50;

Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, Japan
Department of Gastroenterology, Katsuragi Hospital, Kishiwada 596-0825, Japan
Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
Author to whom correspondence should be addressed.
Received: 14 January 2018 / Revised: 9 February 2018 / Accepted: 12 February 2018 / Published: 15 February 2018
(This article belongs to the Special Issue Latest Development in Pancreatic Cancer)
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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. View Full-Text
Keywords: endoscopic ultrasound; EUS; EUS-guided neurolysis; neurolysis; interventional EUS; pancreatic cancer; pain endoscopic ultrasound; EUS; EUS-guided neurolysis; neurolysis; interventional EUS; pancreatic cancer; pain

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Minaga, K.; Takenaka, M.; Kamata, K.; Yoshikawa, T.; Nakai, A.; Omoto, S.; Miyata, T.; Yamao, K.; Imai, H.; Sakamoto, H.; Kitano, M.; Kudo, M. Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis. Cancers 2018, 10, 50.

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