Splanchnicectomy for Pancreatic Cancer Pain

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2014 May 29

PMID 24868557

Citations 5

Authors

Toshiro Masuda

Masafumi Kuramoto

Shinya Shimada

Satoshi Ikeshima

Kenichiro Yamamoto

Kenichi Nakamura

Hideo Baba

Affiliations

Soon will be listed here.

Abstract

Persistent pain is a serious problem that often contributes to a poor quality of life in pancreatic cancer patients. Medical management by opioid analgesics is often accompanied by side effects and incomplete pain relief. A celiac plexus block is a simple treatment which relieves pain, but the procedure demands a certain degree of proficiency and the duration of the effects obtained can be rather limited. Transhiatal bilateral splanchnicectomy achieves a certain denervation of splanchnic nerves, but it requires a laparotomy. Unilateral thoracoscopic splanchnicectomy is a minimally invasive procedure to cause definite denervation. Bilateral thoracoscopic splanchnicectomy is recommended for unsatisfactory cases or recurrent pain occurring after the initial unilateral splanchnicectomy. It is important to select the most suitable treatment depending on patients' actual medical state and the predicted outcomes.

Citing Articles

Pain Control with Splanchnic Neurolysis in Pancreatic Cancer Patients Unresponsive to Celiac Plexus Neurolysis.

Comlek S J Pain Res. 2020; 13:2023-2031.

PMID: 32848449 PMC: 7429208. DOI: 10.2147/JPR.S266689.

Celiac plexus block increases quality of life in patients with pancreatic cancer.

Molnar I, Hegyi G, Zsom L, Saahs C, Vagedes J, Kapocs G J Pain Res. 2019; 12:307-315.

PMID: 30679920 PMC: 6338112. DOI: 10.2147/JPR.S186659.

Fluoroscopy-guided Neurolytic Splanchnic Nerve Block for Intractable Pain from Upper Abdominal Malignancies in Patients with Distorted Celiac Axis Anatomy: An Effective Alternative to Celiac Plexus Neurolysis - A Retrospective Study.

Ahmed A, Arora D Indian J Palliat Care. 2017; 23(3):274-281.

PMID: 28827930 PMC: 5545952. DOI: 10.4103/IJPC.IJPC_28_17.

Road map for pain management in pancreatic cancer: A review.

Lahoud M, Kourie H, Antoun J, El Osta L, Ghosn M World J Gastrointest Oncol. 2016; 8(8):599-606.

PMID: 27574552 PMC: 4980650. DOI: 10.4251/wjgo.v8.i8.599.

Pancreatic stellate cells contribute pancreatic cancer pain via activation of sHH signaling pathway.

Han L, Ma J, Duan W, Zhang L, Yu S, Xu Q Oncotarget. 2016; 7(14):18146-58.

PMID: 26934446 PMC: 4951278. DOI: 10.18632/oncotarget.7776.

References

Issa Y, Ali U, Bouwense S, van Santvoort H, Goor H . Preoperative opioid use and the outcome of thoracoscopic splanchnicectomy in chronic pancreatitis: a systematic review. Surg Endosc. 2013; 28(2):405-12. DOI: 10.1007/s00464-013-3193-z. View

Prasad A, Choudhry P, Kaul S, Srivastava G, Ali M . Thoracoscopic splanchnicectomy as a palliative procedure for pain relief in carcinoma pancreas. J Minim Access Surg. 2009; 5(2):37-9. PMC: 2734898. DOI: 10.4103/0972-9941.55106. View

Leksowski K . Thoracoscopic splanchnicectomy for control of intractable pain due to advanced pancreatic cancer. Surg Endosc. 2001; 15(2):129-31. DOI: 10.1007/s004640090009. View

Nagels W, Pease N, Bekkering G, Cools F, Dobbels P . Celiac plexus neurolysis for abdominal cancer pain: a systematic review. Pain Med. 2013; 14(8):1140-63. DOI: 10.1111/pme.12176. View

Kaufman M, Singh G, Das S, Concha-Parra R, Erber J, Micames C . Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2009; 44(2):127-34. DOI: 10.1097/MCG.0b013e3181bb854d. View

Karapanos K, Nomikos I . Current surgical aspects of palliative treatment for unresectable pancreatic cancer. Cancers (Basel). 2013; 3(1):636-51. PMC: 3756381. DOI: 10.3390/cancers3010636. View

Caraceni A, Portenoy R . Pain management in patients with pancreatic carcinoma. Cancer. 1996; 78(3 Suppl):639-53. DOI: 10.1002/(SICI)1097-0142(19960801)78:3<639::AID-CNCR45>3.0.CO;2-X. View

Krishna S, Chang V, Shoukas J, Donahoo J . Video-assisted thoracoscopic sympathectomy-splanchnicectomy for pancreatic cancer pain. J Pain Symptom Manage. 2001; 22(1):610-6. DOI: 10.1016/s0885-3924(01)00297-4. View

Saenz A, Kuriansky J, Salvador L, Astudillo E, Cardona V, Shabtai M . Thoracoscopic splanchnicectomy for pain control in patients with unresectable carcinoma of the pancreas. Surg Endosc. 2000; 14(8):717-20. DOI: 10.1007/s004640000185. View

10.

Le Pimpec Barthes F, Chapuis O, Riquet M, Cuttat J, Peillon C, Mouroux J . Thoracoscopic splanchnicectomy for control of intractable pain in pancreatic cancer. Ann Thorac Surg. 1998; 65(3):810-3. DOI: 10.1016/s0003-4975(97)01430-6. View

11.

Worsey J, Ferson P, Keenan R, Julian T, Landreneau R . Thoracoscopic pancreatic denervation for pain control in irresectable pancreatic cancer. Br J Surg. 1993; 80(8):1051-2. DOI: 10.1002/bjs.1800800842. View

12.

Cuschieri A, Shimi S, CROSTHWAITE G, Joypaul V . Bilateral endoscopic splanchnicectomy through a posterior thoracoscopic approach. J R Coll Surg Edinb. 1994; 39(1):44-7. View

13.

Smigielski J, Piskorz L, Wawrzycki M, Kutwin L, Misiak P, Brocki M . Assessment of quality of life in patients with non-operated pancreatic cancer after videothoracoscopic splanchnicectomy. Wideochir Inne Tech Maloinwazyjne. 2012; 6(3):132-7. PMC: 3516938. DOI: 10.5114/wiitm.2011.24690. View

14.

Lin C, Mo L, Lin Y, Yau M . Bilateral thoracoscopic lower sympathetic-splanchnicectomy for upper abdominal cancer pain. Eur J Surg Suppl. 1994; (572):59-62. View

15.

Baghdadi S, Abbas M, Albouz F, Ammori B . Systematic review of the role of thoracoscopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2007; 22(3):580-8. DOI: 10.1007/s00464-007-9730-x. View

16.

Stefaniak T, Basinski A, Vingerhoets A, Makarewicz W, Connor S, Kaska L . A comparison of two invasive techniques in the management of intractable pain due to inoperable pancreatic cancer: neurolytic celiac plexus block and videothoracoscopic splanchnicectomy. Eur J Surg Oncol. 2005; 31(7):768-73. DOI: 10.1016/j.ejso.2005.03.012. View

17.

Giraudo G, Kazemier G, van Eijck C, Bonjer H . Endoscopic palliative treatment of advanced pancreatic cancer: thoracoscopic splanchnicectomy and laparoscopic gastrojejunostomy. Ann Oncol. 1999; 10 Suppl 4:278-80. View

18.

Makarewicz W, Stefaniak T, Kossakowska M, Basinski A, Suchorzewski M, Stanek A . Quality of life improvement after videothoracoscopic splanchnicectomy in chronic pancreatitis patients: case control study. World J Surg. 2003; 27(8):906-11. DOI: 10.1007/s00268-003-6837-7. View

19.

Lillemoe K, Cameron J, KAUFMAN H, Yeo C, Pitt H, Sauter P . Chemical splanchnicectomy in patients with unresectable pancreatic cancer. A prospective randomized trial. Ann Surg. 1993; 217(5):447-55; discussion 456-7. PMC: 1242819. DOI: 10.1097/00000658-199305010-00004. View

20.

Johnson C, Berry D, Harris S, Pickering R, Davis C, George S . An open randomized comparison of clinical effectiveness of protocol-driven opioid analgesia, celiac plexus block or thoracoscopic splanchnicectomy for pain management in patients with pancreatic and other abdominal malignancies. Pancreatology. 2010; 9(6):755-63. DOI: 10.1159/000199441. View