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[THE FIRST CLINICAL EXPERIENCE IN THE CELIAC PLEXUS BLOCKADE UNDER ENDOSCOPIC ULTRASOUND NAVIGATION IN PATIENTS WITH PANCREATIC CANCER].

OBJECTIVE
Implementation into clinical practice and getting our own data of the effectiveness of EUS-CPN in chronic pain syndrome associated with pancreatic cancer in the palliative treatment.


MATERIALS AND METHODS
In the period from October 2014 to May 2015 in P.A. Herzen Moscow Research Oncological Institute--filial FGBI "NMIRC" gained the first clinical experience in the celiac plexus blockade under endoscopic ultrasound navigation in 10 patients with pain associated with pancreatic cancer. The study group included 6 women and 4 men aged 54-83 years. In 2 of 10 cases out celiac ganglia were located and injections made in side them. In eight cases, the blockade was performed after injection into the tissue surrounding the celiac trunk. In most cases, we used standard FNA-needle with diameter 22G. Blockade performed by a combination of local anesthetic (3-4 ml of 0.5% bupivacaine) and 14-20 ml of 96% ethanol.


RESULTS
There were no complications after EUS-BCS. 9 of 10 patients (90%) had a significant (2-4 points on a visual analogue scale) reduction of pain after 1-3 days after the procedure. These patients had a significant reduction in the frequency and dosage of analgesics. Four patients required repeat of anesthesia after 2 months--the same with a marked positive effect. One patient, in spite of the double execution of EUS-CPN did not note reduction in pain intensity.


CONCLUSION
EUS-CPN procedure is highly effective, very simple and safe. It provides a high quality of life and of social adaptation oncology patients. It should be more widely used in clinical practice.