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EUS-Guided Celiac Plexus Neurolysis

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Advanced Therapeutic Endoscopy for Pancreatico-Biliary Diseases

Abstract

EUS-guided celiac plexus neurolysis (EUS–CPN) can be performed for alleviating pain originating from the upper abdominal organs and, particularly, when the primary indication for pain is pancreatic cancer pain. Two different techniques are currently used when applying EUS–CPN. The classic approach, known as the central technique, involves injection of a neurolytic agent at the base of the celiac axis, and the second approach, the bilateral technique, involves injection of the neurolytic agent on both sides of the celiac axis. Moreover, it was recently established that celiac ganglia can be examined and visualized by EUS. Therefore, EUS-guided direct celiac ganglia neurolysis (EUS–CGN) has been introduced as a new promising method. These techniques are performed with real-time imaging and with Doppler assessment of the interposing vessels. Therefore, they are more accurate, safe, and convenient than other classic approaches such as radiographic, fluoroscopic, or CT guidance. The effective rates reportedly vary from 50 to 90%. Common complications included transient diarrhea, transient pain exacerbation, transient hypotension, and inebriation, but they are not serious.

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Authors and Affiliations

  1. Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan

    Ichiro Yasuda, Shinpei Doi & Masatoshi Mabuchi

Authors
  1. Ichiro Yasuda
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  2. Shinpei Doi
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  3. Masatoshi Mabuchi
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Editors and Affiliations

  1. Department of Internal Medicine, School of Medicine, University of Tokai, Isehara, Kanagawa, Japan

    Tetsuya Mine

  2. Sankikai Medical Corporation, Yokohama, Kanagawa, Japan

    Rikiya Fujita

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Yasuda, I., Doi, S., Mabuchi, M. (2019). EUS-Guided Celiac Plexus Neurolysis. In: Mine, T., Fujita, R. (eds) Advanced Therapeutic Endoscopy for Pancreatico-Biliary Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-56009-8_14

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  • DOI: https://doi.org/10.1007/978-4-431-56009-8_14

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