Neurolytic procedures for pancreatic cáncer pain: A systematic review and a proposal for an algorithm treatment

Abstract

Pancreatic cancer provokes pain in more than 80 % of patients, resulting in a management of pain that is often unsatisfactory due to the limited treatment options and the signifi cant variation in clinical practice, emphasizing the need for a multidisciplinary approach. This article has been redacted to review the literature and summarize the actual evidence of neurolytic procedures to treat pain caused by pancreatic cancer. The sources of these of articles have been obtained by using PubMed and Medline, restricting the search to randomized control comparative studies, systematic reviews, prospective and retrospective studies, and case series presentations. This article shows the actual evidence of the different approaches for the celiac plexus and splanchnic nerve neurolysis, regarding its effi cacy, risks, adverse effects, and limitations. The fi nal objective has been to propose an interventional algorithm that might help to improve pain management in patients suffering from pancreatic cancer.