Review

Digestive Diseases and Sciences

, Volume 54, Issue 11, pp 2330-2337

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

  • Srinivas R. PuliAffiliated withDivision of Gastroenterology and Hepatology, CE443 Clinical Support & Education, University of Missouri-Columbia Email author 
  • , Jyotsna B. K. ReddyAffiliated withDivision of Gastroenterology and Hepatology, CE443 Clinical Support & Education, University of Missouri-Columbia
  • , Matthew L. BechtoldAffiliated withDivision of Gastroenterology and Hepatology, CE443 Clinical Support & Education, University of Missouri-Columbia
  • , Mainor R. AntillonAffiliated withDivision of Gastroenterology and Hepatology, CE443 Clinical Support & Education, University of Missouri-Columbia
  • , William R. BruggeAffiliated withGI Unit, Massachusetts General Hospital

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Abstract

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.

Keywords

Endoscopic ultrasound Celiac plexus neurolysis Pancreatic cancer Chronic pancreatitis Meta-analysis Systematic review