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Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma.

Publication ,  Journal Article
Allen, PJ; Chou, J; Janakos, M; Strong, VE; Coit, DG; Brennan, MF
Published in: Ann Surg Oncol
March 2011

INTRODUCTION: The efficacy of laparoscopic celiac plexus block (CPB) in patients with unresectable pancreatic cancer has not been reported. METHODS: Patients with elevated pain scores scheduled for laparoscopy for diagnosis/staging of unresectable pancreatic adenocarcinoma were eligible. The study was designed to evaluate 20 consecutive patients with validated quality of life (EORTC QLQ-C30, QLQ-PAN26) and validated pain assessment tools [Brief Pain Inventory (BPI)]. Questionnaires were obtained preoperatively, and postoperatively at 1, 4, and 8 weeks. Laparoscopic CPB was performed by bilateral injection of 20 cc 50% alcohol utilizing a recently described laparoscopic technique. Functional and symptom scoring was performed by EORTC scoring manual. RESULTS: Median age was 61 years (range 42-80 years), and mean preoperative pain score [worst in 24 h on 0-10 visual analogue scale (VAS)] was 7.8 [standard deviation (SD) 1.6]. Median total operative time (laparoscopy + biopsy + CBP) was 57 min (range 29-92 min), and all patients except one were discharged on day of surgery. No major complications occurred. EORTC functional scales did not change significantly during the postoperative period. EORTC symptomatic pain scores decreased significantly. These findings were also observed in the BPI, with significant decreases in visual analogue score for reported mean (preoperative versus week 4, mean: 5.7 versus 2.7; p < 0.01) and worst (preoperative versus week 4, mean: 7.8 versus 5.1; p < 0.01) pain during a 24-h period. CONCLUSIONS: This study documents the efficacy of laparoscopic CPB. The procedure was associated with minimal morbidity, brief operative times, outpatient management, and reduction in pain scores similar to that reported with other approaches to celiac neurolysis.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

March 2011

Volume

18

Issue

3

Start / End Page

636 / 641

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Surveys and Questionnaires
  • Quality of Life
  • Prospective Studies
  • Preoperative Care
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
 

Citation

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ICMJE
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Allen, P. J., Chou, J., Janakos, M., Strong, V. E., Coit, D. G., & Brennan, M. F. (2011). Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma. Ann Surg Oncol, 18(3), 636–641. https://doi.org/10.1245/s10434-010-1372-x
Allen, Peter J., Joanne Chou, Maria Janakos, Vivian E. Strong, Daniel G. Coit, and Murray F. Brennan. “Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma.Ann Surg Oncol 18, no. 3 (March 2011): 636–41. https://doi.org/10.1245/s10434-010-1372-x.
Allen PJ, Chou J, Janakos M, Strong VE, Coit DG, Brennan MF. Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma. Ann Surg Oncol. 2011 Mar;18(3):636–41.
Allen, Peter J., et al. “Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma.Ann Surg Oncol, vol. 18, no. 3, Mar. 2011, pp. 636–41. Pubmed, doi:10.1245/s10434-010-1372-x.
Allen PJ, Chou J, Janakos M, Strong VE, Coit DG, Brennan MF. Prospective evaluation of laparoscopic celiac plexus block in patients with unresectable pancreatic adenocarcinoma. Ann Surg Oncol. 2011 Mar;18(3):636–641.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

March 2011

Volume

18

Issue

3

Start / End Page

636 / 641

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Surveys and Questionnaires
  • Quality of Life
  • Prospective Studies
  • Preoperative Care
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male