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

Abstract EN

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.