Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

Jonathan M. Wyse, Robert Battat, Siyu Sun, Adrian Saftoiu, Ali A. Siddiqui, Ang Tiing Leong, Brenda Lucia Arturo Arias, Carlo Fabbri, Douglas G. Adler, Erwin Santo, Evangelos Kalaitzakis, Everson Artifon, Girish Mishra, Hussein Hassan Okasha, Jan Werner Poley, Jintao Guo, Juan J. Vila, Linda S. Lee, Malay Sharma, Manoop S. BhutaniMarc Giovannini, Masayuki Kitano, Mohamad Ali Eloubeidi, Mouen A. Khashab, Nam Q. Nguyen, Payal Saxena, Peter Vilmann, Pietro Fusaroli, Pramod Kumar Garg, Sammy Ho, Shuntaro Mukai, Silvia Carrara, Subbaramiah Sridhar, Sundeep Lakhtakia, Surinder S. Rana, Vinay Dhir, Anand V. Sahai

Research output: Contribution to journalArticle

Abstract

Objectives: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Methods: Six important clinical questions were determined regarding EUS-CPN. Following a detailed literature review, 6 statements were proposed attempting to answer those questions. A group of expert endosonographers convened in Chicago, United States (May 2016), where the statements were presented and feedback provided. Subsequently a consensus group of 35 expert endosonographers voted based on their individual level of agreement. A strong recommendation required 80% voter agreement. The modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria were used to rate the strength of recommendations and the quality of evidence. Results: Eighty percent agreement was reached on 5 of 6 consensus statements, 79.4% agreement was reached on the remaining one. Conclusions: EUS-CPN is efficacious, should be integrated into the management of pancreas cancer pain, and can be considered early at the time of diagnosis of inoperable disease. Techniques may still vary based on operator experience. Serious complications exist, but are rare.

Original languageEnglish (US)
Pages (from-to)369-375
Number of pages7
JournalEndoscopic Ultrasound
Volume6
Issue number6
DOIs
StatePublished - Nov 1 2017

Keywords

  • Celiac plexus neurolysis
  • Endoscopic ultrasound
  • Guideline
  • Pancreatic cancer

ASJC Scopus subject areas

  • Hepatology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Wyse, J. M., Battat, R., Sun, S., Saftoiu, A., Siddiqui, A. A., Leong, A. T., Arias, B. L. A., Fabbri, C., Adler, D. G., Santo, E., Kalaitzakis, E., Artifon, E., Mishra, G., Okasha, H. H., Poley, J. W., Guo, J., Vila, J. J., Lee, L. S., Sharma, M., ... Sahai, A. V. (2017). Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis. Endoscopic Ultrasound, 6(6), 369-375. https://doi.org/10.4103/eus.eus_97_17