Pancreatic cancer pain: impact and management challenges

Figures & data

Figure 1 Thoracoscopic view of the right hemithorax with a Spl N. lifted with right angle cautery prior to neurectomy.

Abbreviation: Spl N., splanchnic nerve.

Table 1 Summary of studies and their outcomes

Principle authors	Study type	Number of patients	% Successful pain improvement	Other findings	Recommendation of timing for intervention
Puli et al^Citation19	Meta-analysis of EUS CPN	376	63%–80%	Recommend bilateral neurolysis	NA
Lillemoe et al^Citation1	RCT of surgical CPN	137	NA	6 months durability	Early
Iwata et al^Citation16	Retrospective review-EUS CPN	47	0.681	Improved survival with CPN	Early
Wong et al^Citation20	RCT of CPN	153	0.84	No long-term improvement in QOL or survival	Early
Wyse et al^Citation21	RCT of EUS CPN	96		At least 3 months durability, no change in QOL or survival	Early
Pietrabissa et al^Citation17	Prospective cohort of BTS	20	90%–100%	3 months durability, no change in QOL	NA
Seicean et al^Citation15	Prospective cohort of EUS CPN	32	0.75	Improved QOL	Early
Eisenberg et al^Citation18	Meta-analysis of CPN	1,145	0.89	3 months durability	Early
Yan and Myers^Citation22	Meta-analysis of CPN	302	NA	2-3 months durability	Early, if short expected survival

Abbreviations: BTS, bilateral thoracoscopic splanchnicectomy; CPN, celiac plexus neurolysis; EUS, endoscopic ultrasound; NA, not applicable; QOL, quality of life; RCT, randomized control trial.

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