Baba H, Takaki H, Yamada Y, Nakayama T, Iwaki K, Fukuzawa K, Motomura M, Asayama Y. Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study. World J Radiol 2026; 18(10): 126066 [DOI: 10.4329/wjr.126066]
Corresponding Author of This Article
Hiroshi Baba, MD, Department of Radiology, Japan Community Health Care Organization Nankai Medical Center, 7-8 Tokiwanishimachi, Saiki, Oita 876-0857, Japan. babahiroshi@oita-u.ac.jp
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Radiology, Nuclear Medicine & Medical Imaging
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Baba H, Takaki H, Yamada Y, Nakayama T, Iwaki K, Fukuzawa K, Motomura M, Asayama Y. Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study. World J Radiol 2026; 18(10): 126066 [DOI: 10.4329/wjr.126066]
World J Radiol. Oct 28, 2026; 18(10): 126066 Published online Oct 28, 2026. doi: 10.4329/wjr.126066
Computed tomography-guided splanchnic nerve neurolysis outcomes by tumor site in unresectable pancreatic cancer: A single-center retrospective cohort study
Hiroshi Baba, Department of Radiology, Japan Community Health Care Organization Nankai Medical Center, Oita 876-0857, Japan
Hiroshi Baba, Hajime Takaki, Yasunari Yamada, Tomoko Nakayama, Department of Radiology, Oita Red Cross Hospital, Oita 870-0033, Japan
Kentaro Iwaki, Kengo Fukuzawa, Department of Surgery, Oita Red Cross Hospital, Oita 870-0033, Japan
Mitsuteru Motomura, Department of Hepato-Biliary-Pancreatic Internal Medicine, Oita Red Cross Hospital, Oita 870-0033, Japan
Yoshiki Asayama, Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
Author contributions: Baba H, Takaki H, and Yamada Y designed the study; Baba H acquired the data; Baba H and Yamada Y performed the statistical analyses; Baba H, Takaki H, and Yamada Y interpreted the results; Baba H drafted the manuscript; and all the authors critically revised and approved the final version of the manuscript.
AI contribution statement: ChatGPT (OpenAI) was used for language polishing and statistical code development. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Oita Red Cross Hospital on April 16, 2024.
Informed consent statement: The requirement for written informed consent was waived by the Ethics Committee of the Oita Red Cross Hospital because of the retrospective study design.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Data sharing statement: De-identified data are available from the corresponding author upon reasonable request and are subject to institutional and ethical restrictions.
Corresponding author: Hiroshi Baba, MD, Department of Radiology, Japan Community Health Care Organization Nankai Medical Center, 7-8 Tokiwanishimachi, Saiki, Oita 876-0857, Japan. babahiroshi@oita-u.ac.jp
Received: August 7, 2026 Revised: September 16, 2026 Accepted: October 21, 2026 Published online: October 28, 2026 Processing time: 96 Days and 20.4 Hours
Abstract
BACKGROUND
Computed tomography (CT)-guided neurolytic splanchnic nerve block (NSNB) is used to treat pain in unresectable pancreatic cancers. Whether outcomes differ according to tumor site remains uncertain.
AIM
To evaluate the efficacy and safety of CT-guided NSNB in unresectable pancreatic cancer and explore differences by tumor site.
METHODS
This single-center retrospective cohort study included 22 patients who underwent initial CT-guided NSNB at the Oita Red Cross Hospital between 2007 and 2023. Clinical success comprised recorded pain relief or opioid reduction within 1 week; standardized pain scores were not routinely recorded. Technical success required bilateral retrocrural distribution. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE). Proportions were reported with 95% confidence intervals (95%CIs); comparisons used Fisher’s exact and exact permutation Mann-Whitney U tests.
RESULTS
Technical and clinical success occurred in 17/22 (77.3%; 95%CI: 56.6%-89.9%) and 18/22 (81.8%; 95%CI: 61.5%-92.7%), respectively. The recorded duration was available for 13 clinical responders, with a median of 40 days (interquartile range: 19-144 days); four transfers and one death lacked an evaluable duration. The clinical success rates were 6/9 for head tumors and 12/13 for body/tail tumors. The available duration medians were 29.5 days and 117 days, respectively. Adverse events occurred in 6/22 (27.3%; 95%CI: 13.2%-48.2%), with no CTCAE grade ≥ 3 events.
CONCLUSION
CT-guided NSNB is associated with encouraging clinical responses at both tumor sites in this small retrospective cohort. Prospective studies should confirm these findings and clarify potential tumor-site differences.
Core Tip: This retrospective study evaluated outcomes after the initial computed tomography-guided neurolytic splanchnic nerve block in 22 patients with unresectable pancreatic cancer. Clinical success was achieved in 81.8%, with responses observed in both pancreatic head and body/tail tumors. No grade ≥ 3 adverse events were observed. These encouraging findings support further investigation of this approach for pancreatic cancer pain management. Larger prospective studies with standardized outcome assessments are needed to confirm the findings and clarify potential differences by tumor site.
