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Endoscopic ultrasound–guided celiac plexus neurolysis (EUS-CPN) remains a widely used method to treat pain in patients with pancreatic cancer. Most centers inject the celiac ganglia with an anesthetic and a neurolytic agent (usually dehydrated ethanol) to damage nerve fibers and reduce the transmission of pain signals to the brain.
To assess the value of EUS-CPN in this setting, investigators in Japan conducted a prospective, randomized controlled study that compared the use of EUS-CPN plus an opioid medication (oxycodone and/or fentanyl) versus an opioid medication alone in 46 patients with unresectable pancreatic cancer. The primary outcome was pain score assessed on a visual scale at 4 weeks.
Supplementing opioid medication with EUS-CPN di…