scholarly journals Radiofrequency Ablation and Alcohol Neurolysis of the Splanchnic Nerves for a Patient With Abdominal Pain From Pancreatic Cancer

Cureus ◽  
2020 ◽  
Author(s):  
Rana AL-Jumah ◽  
Ivan Urits ◽  
Omar Viswanath ◽  
Alan D Kaye ◽  
Jamal Hasoon
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Radiofrequency Ablation ◽  
Splanchnic Nerves

scholarly journals Computed Tomography-Guided Percutaneous Radiofrequency Ablation of the Splanchnic Nerves as a Single Treatment for Pain Reduction in Patients with Pancreatic Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 303
Author(s):  
Stavros Grigoriadis ◽  
Maria Tsitskari ◽  
Maria Ioannidi ◽  
Periklis Zavridis ◽  
Ioannis Kotsantis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Pain Reduction ◽  
Ductal Adenocarcinoma ◽  
Single Treatment ◽  
Ct Guided ◽  
Splanchnic Nerves ◽  
The Mean

The aim of this paper is to prospectively evaluate the efficacy and safety of percutaneous computed tomography (CT)-guided radiofrequency (RF) neurolysis of splanchnic nerves as a single treatment for pain reduction in patients with pancreatic cancer. Patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication who underwent CT-guided neurolysis of splanchnic nerves by means of continuous radiofrequency were prospectively evaluated for pain and analgesics reduction as well as for survival. In all patients, percutaneous neurolysis was performed with a bilateral retrocrural paravertebral approach at T12 level using a 20 Gauge RF blunt curved cannula with a 1cm active tip electrode. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with numeric visual scale (NVS) units. The mean patient age was 65.4 ± 10.8 years (male-female: 19-11). The mean pain score prior to RF neurolysis of splanchnic nerves was 9.0 NVS units; this score was reduced to 2.9, 3.1, 3.6, 3.8, and 3.9 NVS units at 1 week, 1, 3, 6, and 12 months respectively (p < 0.001). Significantly reduced analgesic usage was reported in 28/30 patients. Two grade I complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system. According to the results of the present study, solely performed computed tomography-guided radiofrequency neurolysis of splanchnic nerves can be considered a safe and efficacious single-session technique for pain palliation in patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication. Although effective in pain reduction the technique seems to have no effect upon survival improvement.

scholarly journals Infected Pancreatic Necrosis Mimicking Pancreatic Cancer

2020 ◽  
Vol 14 (2) ◽  
pp. 436-442
Author(s):  
Jun Heo
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Needle Aspiration ◽  
Infected Pancreatic Necrosis ◽  
Ultrasound Guided ◽  
Fine Needle

Although infected pancreatic necrosis can develop as a result of rare conditions involving trauma, surgery, and systemic infection with an uncommon pathogen, it usually occurs as a complication of pancreatitis. Early phase of acute pancreatitis can be either edematous interstitial pancreatitis or necrotizing pancreatitis. The late complications of pancreatitis can be divided into pancreatic pseudocyst due to edematous interstitial pancreatitis or walled-off necrosis due to necrotizing pancreatitis. During any time course of pancreatitis, bacteremia can provoke infection inside or outside the pancreas. The patients with infected pancreatic necrosis may have fever, chills, and abdominal pain as inflammatory symptoms. These specific clinical presentations can differentiate infected pancreatic necrosis from other pancreatic diseases. Herein, I report an atypical case of infected pancreatic necrosis in which abdominal pain, elevation of white blood cell, and fever were not found at the time of admission. Rather, a 10-kg weight loss (from 81 to 71 kg) over 2 months nearly led to a misdiagnosis of pancreatic cancer. The patient was finally diagnosed based on endoscopic ultrasound-guided fine-needle aspiration. This case highlights that awareness of the natural course of pancreatitis and infected pancreatic necrosis is important. In addition, endoscopic ultrasound-guided fine-needle aspiration should be recommended for the diagnosis and treatment of indeterminate pancreatic lesions in selected patients.

scholarly journals EUS-guided radiofrequency ablation of the celiac axis in pancreatic cancer: Is money worth the pain?

2019 ◽  
Vol 89 (1) ◽  
pp. 207 ◽  
Author(s):  
Alberto Larghi ◽  
Mihai Rimbaş ◽  
Stefano Francesco Crinò
Keyword(s):  
Pancreatic Cancer ◽  
Radiofrequency Ablation ◽  
Celiac Axis

scholarly journals Role of Radiofrequency Ablation in the Management of Unresectable Pancreatic Cancer

2021 ◽  
Vol 7 ◽  
Author(s):  
Muhammad Nadeem Yousaf ◽  
Hamid Ehsan ◽  
Ahmad Muneeb ◽  
Ahsan Wahab ◽  
Muhammad K. Sana ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiofrequency Ablation ◽  
Surgical Resection ◽  
Retrospective Studies ◽  
Advanced Disease ◽  
Protein Denaturation ◽  
Solid Organ ◽  
Unresectable Pancreatic Cancer ◽  
The Past

Pancreatic cancer is one of the most aggressive malignancies of the digestive tract and carries a poor prognosis. The majority of patients have advanced disease at the time of diagnosis. Surgical resection offers the only curative treatment, but only a small proportion of patients can undergo surgical resection. Radiofrequency ablation (RFA) is a well-known modality in the management of solid organ tumors, however, its utility in the management of pancreatic cancer is under investigation. Since the past decade, there is increasing use of RFA as it provides a feasible palliation treatment in the management of unresectable pancreatic cancer. RFA causes tumor cytoreduction through multiple mechanisms such as coagulative necrosis, protein denaturation, and activation of anticancer immunity. The safety profile of RFA is controversial because of the high risk for complications, however, small prospective and retrospective studies have shown promising results in its applicability for palliative management of unresectable pancreatic malignancies. In this review, we discuss different approaches of RFA, their indications, technical accessibility, safety, and major complications in the management of unresectable pancreatic cancer.

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