Mehrdad Mokaram Dori - Pain Fellowship, Mashhad University of Medical Sciences

Preface Pancreatic cancer is a common cancer pain problem in Iran and unfortunately most of the patients have limited life span due to the malignant nature of the disease. Palliation is the main treatment for many of this patients and pain control is a challenge. Methods Many pain killers from different classes should prescribe as the first line therapy to control neuropathic and nociceptive nature of complicated chronic cancer pain. Moreover, many of these cases do not respond to multidrug therapy enough as the tumor invades to the surrounding tissues and need to more invasive neurolytic procedures like splanchnic plexus neurolysis or celiac ganglion neurolysis with radiofrequency or alcohol. Besides, a few methods have been described to reach the target like CT or fluoroscopic guided splanchnic neurolysis, CT or fluoroscopic guided celiac ganglion neurolysis and recently, Endoscopic ultrasound guided celiac ganglion neurolysis. Results and conclusions This study reviews recent studies for invasive celiac plexus neurolysis and discuss about different approaches for celiac plexus or ganglion neurolysis, alcohol or radiofrequency as the neurolytic agents and benefits or drawbacks of each one.

Celiac plexus, celiac ganglion, radiofrequency catheter ablation