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Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis in Pancreatic Cancer: A Prospective Pilot Study of Safety Using 10?mL versus 20?mL Alcohol.

Leblanc JK, Rawl S, Juan M, Johnson C, Kroenke K, McHenry L, Sherman S, McGreevy K, Al-Haddad M, Dewitt J. Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis in Pancreatic Cancer: A Prospective Pilot Study of Safety Using 10?mL versus 20?mL Alcohol. Diagnostic and therapeutic endoscopy. 2013 Jan 8; 2013:327036.

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Abstract:

Background. The dose of alcohol used in EUS-CPN is not standardized. The objective was to compare the safety of 20?mL alcohol versus 10?mL alcohol during EUS-CPN for patients with pancreatic cancer-related pain. Methods. 20 patients were selected to receive 10?mL or 20?mL of alcohol during EUS-CPN. Followup was done at baseline, 24 hours, and weekly. Health-related quality of life (HRQoL) was assessed at baseline, week 2, week 4, and every 4 weeks thereafter until pain returned. Results. There were no major complications in both groups. Minor self-limited adverse effects were seen in 6 (30%) subjects and included lightheadedness in 1 (5%), transient diarrhea in 2 (10%), and transient nausea and vomiting in 3. Pain relief was similar in both groups: 80% in the 10?mL group and 100% in the 20?mL group (P = 0.21). The mean (±?SD) duration of pain relief in the 10?mL and 20?mL groups was 7.9 ± 10.8 and 8.4 ± 9.2 weeks, respectively. 30% of patients in each group had complete pain relief. Conclusions. EUS-CPN using 20?mL of alcohol is safe. Similar clinical outcomes were seen in both groups. Further investigations to confirm these findings are warranted.




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