Ahmed Moustafa Mohamed Kassem
Alexandria University, Egypt
Title: Role of imaging guided celiac nerve neurolysis in alleviating intractable cancer related abdominal pain.
Biography
Biography: Ahmed Moustafa Mohamed Kassem
Abstract
Abdominal pain is a common debilitating problem in patients with abdominal malignancy and often dramatically affects quality of life and survival .Management of cancer-related abdominal pain is a complex and challenging issue and often necessitates chronic use of high-dose narcotic analgesics, which, in turn, are generally associated with several adverse effects. Percutaneous celiac neurolysis can be performed with high success and low complication rates under imaging guidance to obtain pain relief in such patients. Celiac plexus nerolysis may also be effectively performed for pain relief in patients with chronic pancreatitis although with less effectiveness. Follow up of our patients had been continued for a 12 month interval, and near total pain relieve was noted in almost our patients. Using percutanous imaging guidance (CT or US), celiac plexus neurolysis was done through anterior or posterior approach. All our patients were sedated. A full sterile technique was used. A mixture of ethanol (95%) , bupivacaine and contrast material was used. 20-40 ml were injected. Follow up of the patient according pain score was done. Near total pain relief was noted in most of our patients with no significant complications and their follow up was satisfactory. CT guidance celiac neurolysis is the preferred technique thanks to adequate anatomical characterization with accurate monitoring of the alcohol diffusion during injection.