Endoscopic ultrasound celiac plexus block and neurolysis

Over the last decade, endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis (CPN) have been established as effective and safe interventions to palliate visceral abdominal pain resulting from chronic pancreatitis and pancreatic cancer, respectively. Endoscopic ultrasound-guided approach has advantages over the percutaneous methods because it facilitates precise injection into the region owing to its more direct access. More recently, celiac ganglion neurolysis has been promoted as a safe alternative to CPN and it may be a more efficacious technique than CPN. Although large, adequately powered randomized trials are lacking, observational studies and small randomized trials support the use of celiac plexus block and CPN in palliation of pain in patients with chronic pancreatitis or pancreatic cancer, respectively. However, these interventions' affect on quality of life and survival is unclear and further large randomized studies are needed.