Obstein KL, Martins FP, Fernández-Esparrach G, Thompson CC. Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer. World J Gastroenterol 2010; 16(6): 728-731 [PMID: 20135721 DOI: 10.3748/wjg.v16.i6.728]
Corresponding Author of This Article
Christopher C Thompson, MD, MSc, FACG, FASGE, Gastroenterology Division, Brigham and Women’s Hospital, 75 Francis Street, Thorn 1123, Boston, MA 02115, United States. ccthompson@partners.org
Article-Type of This Article
Brief Article
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World J Gastroenterol. Feb 14, 2010; 16(6): 728-731 Published online Feb 14, 2010. doi: 10.3748/wjg.v16.i6.728
Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer
Keith L Obstein, Fernanda P Martins, Gloria Fernández-Esparrach, Christopher C Thompson
Keith L Obstein, Christopher C Thompson, Gastroenterology Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States
Fernanda P Martins, Federal University of São Paulo, Rua Botucatu, 640 2° andar, São Paulo 04023-062, Brazil
Gloria Fernández-Esparrach, Department of Gastroenterology, Endoscopy Unit, Hospital Clinic, Villarroel 170, Barcelona 08036, Spain
Author contributions: Obstein KL, Martins FP, Fernández-Esparrach G and Thompson CC contributed equally to this work; Obstein KL, Martins FP, Fernández-Esparrach G and Thompson CC performed the research; Obstein KL, Martins FP, Fernández-Esparrach G and Thompson CC analyzed the data; Obstein KL, Martins FP, Fernández-Esparrach G and Thompson CC wrote the paper.
Supported by A grant from Generalitat de Catalunya (AGAUR, BE-100022)
Correspondence to: Christopher C Thompson, MD, MSc, FACG, FASGE, Gastroenterology Division, Brigham and Women’s Hospital, 75 Francis Street, Thorn 1123, Boston, MA 02115, United States. ccthompson@partners.org
Telephone: +1-617-5258266 Fax: +1-617-2646342
Received: April 25, 2009 Revised: November 4, 2009 Accepted: November 11, 2009 Published online: February 14, 2010
Abstract
AIM: To assess the feasibility of endoscopic ultrasound (EUS)-guided celiac plexus neurolysis (CPN) using a poloxamer.
METHODS: In this prospective evaluation, six Yorkshire pigs underwent EUS-guided CPN. Three received an injection of 10 mL of 0.25% Lidocaine plus methylene blue (group 1) and three received an injection of 10 mL of 0.25% Lidocaine plus blue colored poloxamer (PS137-25) (group 2). Necropsy was performed immediately after the animals were sacrificed. The abdominal and pelvic cavities were examined for the presence of methylene blue and the blue colored poloxamer.
RESULTS: EUS-guided CPN was successfully performed in all 6 pigs without immediate complication. Methylene blue was identified throughout the peritoneal and retroperitoneal cavity in group 1. The blue colored poloxamer was found in the retroperitoneal cavity immediately adjacent to the aorta, in the exact location of the celiac plexus in group 2.
CONCLUSION: EUS-guided CPN using a reverse phase polymer in a non-survival porcine model was technically feasible. The presence of a poloxamer gel at the site of the celiac plexus at necropsy indicates a precise delivery of the neurolytic agent.
