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Treatment Options for Chronic Pancreatitis
Celiac Plexus Block (Nerve Block) for Chronic Pancreatitis
As a last resort for patients with chronic pancreatitis (CP) who do not respond to other treatment, a nerve block that anesthetizes the pain-conducting nerve center (celiac ganglion or plexus), may be performed. It is a more aggressive intervention that is considered for patients with advanced stage CP who are refractory to oral pain management. This is usually achieved by injecting alcohol directly into the celiac ganglion percutaneously (passing a needle through the skin) under X-ray or ultrasound guidance which blocks the transmission of pain signals. Other agents that may be used in addition to alcohol include steroids and/or local anesthetics.
The procedure is considered to be safe and effective (up to 85% of patients) but it provides only short-term relief and may need to be repeated. Sometimes a neurolytic agent that destroys nerve tissue may be needed instead of an anesthetic. This technique has not proven to be effective in young patients who have undergone surgery.
Celiac block can also be performed with the help of endoscopic ultrasound which is a more recent advancement. This procedure continues to undergo development.
In a related procedure, nerve fibers can be disconnected or cut instead of anesthetized in a procedure referred to as splanchenectomy or splanchenic nerve block.
