Techniques and results of neurolysis for chronic pancreatitis and pancreatic cancer pain

被引：41

作者：

Noble M. ^{[1
]}

Gress F.G. ^{[1
]}

机构：

[1] Division of Gastroenterology, Duke University Medical Center, Durham

来源：

Current Gastroenterology Reports | 2006年 / 8卷 / 2期

关键词：

Pancreatic Cancer; Chronic Pancreatitis; Bupivacaine; Celiac Trunk; Chronic Abdominal Pain;

D O I：

10.1007/s11894-006-0004-x

中图分类号：

学科分类号：

摘要：

Chronic abdominal pain can be associated with benign and malignant disease. Pain associated with pancreatic cancer and chronic pancreatitis can be severely debilitating, with significant impairment in quality of life. Frequently, chronic abdominal pain is not adequately responsive to conventional medical therapies, including nonsteroidal anti-inflammatory drugs and opioids. For this reason, alternative methods to alleviate pain have been developed. Celiac plexus neurolysis and celiac block involve injecting an agent at the celiac axis, with the goal of either selectively destroying the celiac plexus or temporarily blocking visceral afferent nociceptors to alleviate chronic abdominal pain. Agents most commonly used for this purpose include alcohol or phenol for neurolysis and bupivacaine and triamcinolone for temporary block. Methods to administer such agents to the celiac ganglion include CT imaging, percutaneous ultrasound, fluoroscopy, endoscopic ultrasound, or surgery (ganglionectomy). Response rates and complications vary depending on technique but are relatively low. This review highlights the techniques of celiac plexus neurolysis and celiac block and their status in the treatment of chronic pancreatitis and pancreatic cancer pain. Copyright © 2006 by Current Science Inc.

引用

页码：99 / 103

页数：4

共 42 条

[1]

Friberg G., Kindler H.L., Chemotherapy for advanced pancreatic cancer: Past, present, and future, Curr Oncol Rep, 7, pp. 186-195, (2005)

[2]

Wehler M., Nichterlein R., Fischer B., Et al., Factors associated with health-related quality of life in chronic pancreatitis, Am J Gastroenterol, 99, pp. 138-146, (2004)

[3]

Lebovits A.H., Lefkowitz M., Pain management of pancreatic carcinoma: A review, Pain, 36, pp. 1-11, (1989)

[4]

Reidenberg M.M., Portenoy R.K., The need for an open mind about the treatment of chronic nonmalignant pain, Clin Pharmacol Ther, 55, pp. 367-369, (1994)

[5]

Weissman D.E., Haddox J.D., Opioid pseudoaddiction: An iatrogenic syndrome, Pain, 36, pp. 363-366, (1989)

[6]

Zenz M., Strumpf M., Tryba M., Long-term oral opiold therapy in patients with chronic nonmalignant pain, J Pain Symptom Manage, 7, pp. 69-77, (1992)

[7]

Ward E.M., Rorie D.K., Nauss L.A., Bahn R.C., The celiac ganglia in man: Normal anatomic variations, Anesth Analg, 58, pp. 461-465, (1979)

[8]

Nagakawa T., Mori K., Nakano T., Et al., Perineural invasion of carcinoma of the pancreas and biliary tract, Br J Surg, 80, pp. 619-621, (1993)

[9]

Kirchgessner A.L., Gershon M.D., Innervation of the pancreas by neurons in the gut, J Neurosci, 10, pp. 1626-1642, (1990)

[10]

Kappis M., Senibilitat und lokale Anasthesie im chirurgischen Gebiet der Bauchhohle mit besonderer Berucksichtigung der splanchnicus-Aasthesic, Beitrage Zur Klinischen Chirurgie, 115, pp. 161-175, (1919)

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