ArticleIndian journal of palliative care
Computed Tomography-Guided Versus Fluoroscopy-Guided Celiac Plexus Neurolysis for Pancreatic Cancer Pain: A Novel Comparative Study Integrating Pain Phenotyping and Functional Outcomes.
Article in Indian journal of palliative care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: The aim of this study was to evaluate and compare the efficacy, safety, opioid-sparing effect and functional outcomes of computed tomography (CT)-guided versus fluoroscopy-guided celiac plexus neurolysis (CPN) in managing pancreatic cancer pain. The study integrates pain phenotyping using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale to assess response in neuropathic subtypes. Materials and Methods: This was an ambispective observational study conducted at King George's Medical University, encompassing a retrospective cohort (January 2020-December 2022) and a prospective cohort (January 2023-December 2024). Sixty patients with histologically confirmed pancreatic adenocarcinoma and baseline pain scores of ≥7 on the visual analogue scale (VAS) were included. Patients underwent bilateral posterior retrocrural CPN under either CT ( Results: Both groups were comparable at baseline in terms of age, sex and initial pain scores. The mean VAS decreased from 8.9 ± 1.2 to 5.4 ± 2.1 in the CT group and from 8.8 ± 1.1 to 5.8 ± 2.3 in the fluoroscopy group at 3 months ( Conclusion: Both CT and fluoroscopy-guided CPN provide effective pain relief in pancreatic cancer. However, CT-guided CPN is associated with significantly greater pain reduction, especially in patients with neuropathic pain features, lower complication rates and better functional outcomes. Pain phenotyping using LANSS enhances procedural decision-making and supports a personalised approach to palliative care in pancreatic malignancy.
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