PERCUTANEOUS NEUROLYSIS OF THE CELIAC PLEXUS VIA THE ANTERIOR APPROACH WITH SONOGRAPHIC GUIDANCE

OBJECTIVE. The purpose of this study was to evaluate the usefulness of sonographically guided percutaneous neurolysis of the celiac plexus i n patients with abdominal tumors or chronic pancreatitis in whom syste mic analgesics were ineffective. SUBJECTS AND METHODS. Neurolysis of t he celiac plexus was performed in 38 patients, 34 with neoplastic dise ase and four with chronic pancreatitis. Under sonographic guidance, a 22-gauge needle was advanced by the anterior route to the area above t he celiac plexus, and 30-40 ml of 50% alcohol was injected. Pain relie f was assessed 1 week, 6 months, and 1 year after the procedure. Patie nts subjectively rated the pain after treatment as totally relieved, p artially relieved, or unchanged. RESULTS. At 1 week and at 6 months af ter treatment, pain was totally relieved in 61% of patients, partially relieved in 31%, and unchanged in 8%. After 1 year, pain was totally relieved in 39%, partially relieved in 52%, and unchanged in 9%. The c omplications observed were five cases of mild diarrhea and one case of retroperitoneal pain, which subsided with conservative treatment. CON CLUSION. The anterior, sonographically guided approach appears to be a s successful as other percutaneous techniques for neurolysis of the ce liac plexus.