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Copyright ©The Author(s) 2021.
World J Gastrointest Endosc. Oct 16, 2021; 13(10): 460-472
Published online Oct 16, 2021. doi: 10.4253/wjge.v13.i10.460
Table 1 Contraindications of endosonography-guided celiac plexus neurolysis
Absolute
Relative
Resectable pancreatic cancerEsophagueal or gastric varices[21,26]
Coagulopathy (INR > 1.5)Previous gastric surgery[2,14]
Low platelet count (< 50000 units)Anomalies of celiac trunk[12]
Table 2 Endosonography-guided celiac plexus neurolysis efficacy in current literature
Ref.
Design
n
Technique
Neurolytic agent
Pain control (follow up)
Complications
Wiersema et al[6]Retrospective30Bilateral3 mL bupivacaine (0.25%) + 10 mL ethanol (98%)88% (10 wk)Diarrhea 13.3%, Pain 3.3%
Gunaratnam et al[17]Prospective58Bilateral3-6 mL bupivacaine (0.25%) + 10 mL ethanol (98%)78% (24 wk)Pain 8.6%
Levy et al[11]Retrospective17Direct8 mL bupivacaine (0.25%) + 12 mL ethanol (99%)94% (2-4 wk)Hypotension 35%, pain 41% and diarrhea 16%
Sahai et al[9]Prospective160Central vs Bilateral10 mL bupivacaine (0.5%) + 20 mL ethanol45.9% vs 70.5% (7 d). P < 0.05Bleeding 0.7%
Sakamoto et al[18]Retrospective67Broad vs bilateral3 mL lidocaine (1%) + 9 mL ethanol (98%)Mean VAS scores 3.9 vs 2.5 (7 d) and 4.8 vs a 3.4 (30 d) P < 0.05None
Wyse et al[7]RCT48Bilateral vs analgesia10 mL bupivacaine (0.50%) + 20 mL ethanolLikert scale reduction 28% (4 wk) + 60% (12 wk) P < 0.05None
LeBlanc et al[10]RCT50Central vs bilateral20 mL lidocaine (0.75%) + 10 mL ethanol (98%)69% vs 81% (61.9%)(14wk) Hypotension 2% pain 36%
Iwata et al[19]Retrospective47Central, direct or bilateral2-3 mL bupivacaine + 20 mL ethanol68% (7 wk)Hypotension 17%, diarrhea 23% and inebriation 8%
Ascunce et al[20]Retrospective64Bilateral10 mL lidocaine (1%) + 20 mL ethanol (98%)50% (1 wk). OR 15.61 of response if celiac ganglia was detectedHypotension 2%, pain 2% and diarrhea 23%
Wiechowska-Kozłowska et al[12]Retrospective29Central vs bilateral 2 mL lidocaine (2%) + 20 mL ethanol (98%)86% (1-2 wk)Hypotonia 3.4%, pain 6.9% and diarrhea 10.3%
Téllez-Ávila et al[21]Retrospective53Central vs bilateral10 mL lidocaine (1%) + 10-20 mL ethanol (98%)48% vs 56% (4 wk) Transitory pain 0% vs 3%
Seicean et al[22]Retrospective32Central10 mL lidocaine (1%) + 10-15 mL ethanol75% (2 wk)None
Doi et al[13]RCT68Direct vs central1-2 mL bupivacaine (0.25%-0.5%) + 10-20 mL ethanol73.5% vs 45.5% (7 d) P < 0.05Hypotension 2.9% vs 6%, pain 29.4% vs 21.2% and diarrhea 5.9% vs 9.1%. No diferences
Ishiwatari et al[16]Retrospective22Direct or bilateral1-2 mL bupivacaine (0.5%) + 40-60 mL ethanol or 20-25 mL fenol83% (fenol) vs 69% (ethanol) (7 d)Diarrhea 9%, hypotension 4.5%, pain 4.5% and inebriation 4.5%
Hao et al[23]Retrospective41Central or direct10 mL bupivacaine (2%) + 20 mL ethanolPain < 3 mo improve 84% (3 d), 96% (7 d) and 68% (90 d). Pain > 3 mo improve 75% (3 d), 81% (7 d) and 50% (90 d)Hypotension 4.9%
Minaga et al[14]Retrospective observational112Broad ± direct3 mL lidocaine (1%) + 9 mL ethanol (98%)Pain improvement 77. 7% (1 wk)+ 67.9% (4 wk)Inebriation 8%, hypotension 4.5%, pain 3.6% and diarrhea 3.6%
Levy et al[24]RCT110Direct vs bilateral4 mL bupivacaine (0.25%) + 20 mL ethanol (99%)Pain improvement 46.2% vs 40.4%. No changes on quality of lifeHypotension 11.7% vs 20%, diarrhea 10% vs 12.2%. Pain 8.3% vs 44.9% (P < 0.05)