Year 2019 / Volume 26 / Number 6

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Review

Neurolytic procedures for pancreatic cáncer pain: a systematic review and a proposal for an algorithm treatment

Rev. Soc. Esp. Dolor. 2019; 26(6): 342-358 / DOI: 10.20986/resed.2019.3715/2018

Manuel Herrero Trujillano, Agustín Mendiola de la Osa, Joaquín Insausti Valdivia, Juan Pérez-Cajaraville


ABSTRACT

Pancreatic cancer provokes pain in more than 80 % of patients, resulting in a management of pain that is often unsatisfactory due to the limited treatment options and the significant variation in clinical practice, emphasizing the need for a multidisciplinary approach. This article has been redacted to review the literature and summarize the actual evidence of neurolytic procedures to treat pain caused by pancreatic cancer. The sources of these of articles have been obtained by using PubMed and Medline, restricting the search to randomized control comparative studies, systematic reviews, prospective and retrospective studies, and case series presentations. This article shows the actual evidence of the different approaches for the celiac plexus and splanchnic nerve neurolysis, regarding its efficacy, risks, adverse effects, and limitations. The final objective has been to propose an interventional algorithm that might help to improve pain management in
patients suffering from pancreatic cancer.



RESUMEN

El cáncer de páncreas produce dolor en más del 80 % de los pacientes, con un manejo analgésico en ocasiones insatisfactorio debido a las opciones terapéuticas limitadas y a la variación de la práctica clínica, siendo necesario un manejo multidisciplinar. El desarrollo de este artículo ha consistido en revisar la literatura y resumir la evidencia actual de los procedimientos intervencionistas neurolíticos para manejar el dolor visceral asociado al cáncer de páncreas. La fuente de artículos de esta revisión se ha obtenido a través de PubMed y Medline, limitando la búsqueda a ensayos controlados y aleatorizados, revisiones sistematizadas, estudios prospectivos y retrospectivos y presentaciones de series de casos. Se muestra la evidencia actual de los diferentes abordajes para la neurólisis del plexo celiaco y de los nervios esplácnicos, describiendo su eficacia, riesgos, complicaciones y limitaciones. El objetivo final ha sido establecer una propuesta de algoritmo intervencionista que pueda mejorar el manejo del dolor en los pacientes que sufren dolor visceral debido al cáncer de páncreas.





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Herrero Trujillano M, Mendiola de la Osa A, Insausti Valdivia J, Pérez-Cajaraville J. Neurolytic procedures for pancreatic cáncer pain: a systematic review and a proposal for an algorithm treatment. Rev Soc Esp Dolor 2019; 26(6): 342-358 / DOI: 1020986/resed20193715/2018


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Publication history

Received: 08/11/2018

Accepted: 29/06/2019

Online First: 09/10/2019

Published: 11/12/2019

Article revision time: 221 days

Article Online First time: 335 days

Article editing time: 398 days


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