Alleviating visceral cancer pain in patients with pancreatic cancer using cryoablation and celiac plexus block

Little is known about the effects of pancreas cryoablation (PCA) on abdominalgia in pancreatic cancer patients or its synergism with celiac plexus block (CPB). In patients without abdominalgia, to investigate the effects of PCA; in patients with abdominalgia, to investigate the pain-alleviating effects of PCA + CPB. Sixty-two patients were enrolled in this retrospective review; 12 without abdominalgia refused PCA, 15 without abdominalgia received PCA to reduce their tumor load and 35 with abdominalgia received PCA + CPB to reduce tumor load and alleviate pain. All PCA and PCA + CPB procedures were performed successfully. Some slight adverse effects (e.g. increased serum amylase, abdominal distension and nausea, abdominal bleeding) had disappeared by 3 weeks, spontaneously or after symptomatic treatment. In patients without abdominalgia, pain occurred in one-third of cases (all with pancreatic head cancer) after PCA but had stopped 1–12 days after treatment; in patients with abdominalgia before treatment, pain stopped immediately after PCA + CPB in 18 cases and 2–24 days after treatment in 17 (all with pancreatic head cancer); a significant difference was found between pretreatment and post-treatment pain frequency (P = 0.0019), regardless of the presence of advanced (P = 0.0096) or metastatic (P = 0.0072) cancer. The average time to pain relief was approximately 7 days after both PCA and PCA + CPB, and abdominalgia did not recur for more than 8 weeks. PCA may cause short-term pain in some pancreatic cancer patients. Combined PCA + CPB can alleviate cancer pain for more than 8 weeks, without severe side effects.