Percutaneous computed tomography guided cryoablation of the celiac plexus as an alternative treatment for intractable pain caused by pancreatic cancer

Computed Tomography (CT)-guided percutaneous cryoablation was performed in a 43-year-old patient with intractable epigastric abdominal pain caused by advanced adenocarcinoma of the pancreas and extensive celiac trunk involvement. Initial treatment with celiac plexus nerve neurolysis using local etha...

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Bibliographic Details
Published in:Journal of cancer research and therapeutics 2011-10, Vol.7 (4), p.481-483
Main Authors: Yarmohammadi, Hooman, Nakamoto, Dean A, Azar, Nami, Hayek, Salim M, Haaga, John R
Format: Article
Language:English
Subjects:
Adult
Care and treatment
Case studies
Celiac Plexus - surgery
Cryosurgery - methods
CT imaging
Diagnosis
Health aspects
Humans
Intractable pain
Male
Pain
Pain management
Pain, Intractable - surgery
Pancreatic cancer
Pancreatic Neoplasms - physiopathology
Tomography
Tomography, X-Ray Computed
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Summary:Computed Tomography (CT)-guided percutaneous cryoablation was performed in a 43-year-old patient with intractable epigastric abdominal pain caused by advanced adenocarcinoma of the pancreas and extensive celiac trunk involvement. Initial treatment with celiac plexus nerve neurolysis using local ethanol injection was unsuccessful. A 17-gauge 17-cm cryoablation probe (Galil Medical Inc. Plymouth Meeting, PA) was placed into the expected location of the celiac plexus through a left paraspinal approach under CT guidance and two cycles of freeze-thaw were performed. Patient's pain decreased from 10 of 10 (subjective pain scoring using a visual analog scale; VAS; 0-10) to 3. No post-procedure complication was observed. His pain has remained stable after 6 months of follow up. Percutaneous cryoablation appears to be an effective alternative to neurolytic celiac plexus block for palliative treatment of celiac plexus involvement. Further study with larger number of patients is needed to evaluate the safety and efficacy.
ISSN:0973-1482
1998-4138
DOI:10.4103/0973-1482.92024