Celiac plexus neurolysis (CPN) is one method of controlling the pain associated with pancreatic cancer, which can be severe and disabling for the patient.
The celiac plexus provides nerve fibers to the region of the pancreas. Destruction of the celiac plexus interrupts pain transmission to the brain.
Criteria for selecting a patient for celiac axis neurolysis - all of the following:
(1) The patient has pancreatic cancer.
(2) The patient has severe pain that is causing a poor quality of life for the patient.
(3) Pharmacologic therapy is ineffective or associated with significant side effects.
(4) The person providing neurolysis is experienced with the method being used.
(5) The patient provides informed consent.
Celiac plexus neurolysis can be achieved in many ways:
(1) direct surgical excision of the plexus
(2) injection of ethanol or phenol with guidance by ultrasonography, fluoroscopy, laparoscopy or other methods
(3) cryoablation
(4) radiofrequency ablation
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