The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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A Case of Thoracoscopic Splanchnicectomy for Relief of Intractable Pain in Pancreatic Cancer -A case report-

췌장암 환자에서 난치성 통증에 대한 흉강경을 통한 내장신경 절제술 -증례 보고-

  • Kim, Do Hyung (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Shim, Je Kwang (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Moon, Jin Chun (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Yoon, Kyung Bong (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Kim, Won Oak (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Yoon, Duck-Mi (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine)
  • 김도형 (연세대학교 의과대학 마취통증의학교실) ;
  • 심재광 (연세대학교 의과대학 마취통증의학교실) ;
  • 문진천 (연세대학교 의과대학 마취통증의학교실) ;
  • 윤경봉 (연세대학교 의과대학 마취통증의학교실) ;
  • 김원옥 (연세대학교 의과대학 마취통증의학교실) ;
  • 윤덕미 (연세대학교 의과대학 마취통증의학교실)
  • Received : 2006.02.08
  • Accepted : 2006.04.21
  • Published : 2006.06.30
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Abstract

Pancreatic cancer often elicits intractable abdominal pain which has significant negative impact on the quality of life in patients. Various therapeutic modalities including celiac plexus block are being used to alleviate the pain. The anatomic location of the pancreas often hinders the spread of anesthetic or neurolytic solutions by obliterating the retrocrural space, thus making the classic retrocrural approach unsuccessful. The following case describes a patient with intractable abdominal pain originating from advanced pancreatic cancer, which could be managed successfully with thoracoscopic splanchnicectomy after retrocrural celiac plexus block had failed.

Keywords

References

  1. Wong GY, Schroeder DR, Cams PE, Wilson JL, Martin DP, Kinney MO, et al: Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA 2004; 291: 1092-9 https://doi.org/10.1001/jama.291.9.1092
  2. Rykowski JJ, Maciej H: Efficacy of neurolytic celiac plexus block in varying locations of pancreatic cancer: influence on pain relief. Anesthesiology 2000; 92: 347-58 https://doi.org/10.1097/00000542-200002000-00014
  3. Melki J, Riviere j, Roullee N, Soury P, Pellon C, Testart C: Spianchnicectomie thoracique sous videothoracoscopie. Presse Med 1993; 22: 1095-7
  4. Thanakumar JAC, Chintapatla S: Thoracoscope pancreatic denervation for pain control in irresectable pancreatic cancer. Br J Surg 1994; 81: 149
  5. Lin CC, Mo LR, Lin YW, Yau MP: Bilateral thoracoscopic lower sympathetic-splanchnicectomy for upper abdominal cancer pain. Eur J Surg 1994; 572(Suppl): 59-62
  6. Takahashi T, Kakita A, Izumika H, lino Z, Furuta K, Yoshida KM, et al: Thoracoscopic splanchicectomy for the relief of intractable abdominal pain. Surg Endosc 1996; 10: 65-8 https://doi.org/10.1007/s004649910017
  7. Chae YS, Lee WJ, Paik HC, Lee JH, Kim KS, Kim BR: Tho-rascopic splanchnicectomy for the relief of intractable upper abdominal cancer pain. J Kor Surg Soc 2001; 60: 73-7
  8. Rosenthal JA: Diaphragmatic paralysis complicating alcohol splanchnic nerve block. Anesth Analg 1998; 86: 845-6 https://doi.org/10.1097/00000539-199804000-00030
  9. Rykowski JJ, Maciej H: Efficacy of neurolytic celiac plexus block in varying locations of pancreatic cancer: influence on pain relief. Anesthesiology 2000; 92: 347-58 https://doi.org/10.1097/00000542-200002000-00014
  10. Leung JWC, Bowenwright M, Aveling W, Shorvon PJ, Cotton PB: Coeliac plexus block for pain in pancreatic cancer and chronic pancreatitis. Br J Surg 1983; 70: 730-2 https://doi.org/10.1002/bjs.1800701212
  11. Sunanda K, Victor TC, Jerry AS, James D: Video-assisted thoracoscope sympathectomy-splanchnicectomy for pancreatic cancer pain. J Pain Symptom Manage 2001; 22: 611-4
  12. Sastre B, Carabalona B, Crespy B, Delpero JR: Transhiatal bilateral splanchnicotomy for pain control in pancreatic cancer: Basic anatomy, surgical technique and immediate results in fifty-one cases. Surgery 1996; 111: 640-6
  13. Lee HG, Yoon DM, Oh HK: A clinical evaluation of splanchnic nerve block with absolute ethanol. Korean J Pain 1991; 4: 116-7
  14. Marc N, Marc M, Jan D, Walter V: Thoracoscopic splanchni-colysis for the pain relief of chronic pancreatitis pain. Chest 1998; 113: 528-31 https://doi.org/10.1378/chest.113.2.528
  15. Sunanda K, Victor TC, Jerry AS, James D: Video-assisted thoracoscopic sympathectomy-splanchnicectomy for pancreatic cancer pain. J Pain Symptom Manage 2001; 22: 611-4
  16. Stefaniak T, Basinski A, Vingerhoets A, Makarewicz W, Connor S, Kaska L, et al: A comparison of two invasive techniques in the management of intractable pain due to inoperable pancreatic cancer: neurolytic celiac plexus block and videothoracoscopic splan-chnicectomy. Eur J Surg Oncol 2005; 31: 768-73 https://doi.org/10.1016/j.ejso.2005.03.012