Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 30;39(2):138-141.
doi: 10.1055/s-0042-1745762. eCollection 2022 Apr.

Celiac Plexus Cryoneurolysis

Aron Chary  1 , Faramarz Edalat  2
Affiliations
Review

Celiac Plexus Cryoneurolysis

Aron Chary et al. Semin Intervent Radiol. .

Abstract

Intractable, chronic abdominal pain from upper abdominal malignant and benign diseases is a significant challenge for healthcare providers and burden on the healthcare system. While opioid analgesics are commonly used to provide pain relief, the adverse effects of chronic opioid use cannot be overlooked. Celiac plexus neurolysis via chemical or thermal means represents an alternative minimally invasive approach to provide palliative pain relief and increase patients' quality of life. Through the use of computed tomography guidance, celiac plexus neurolysis can be performed by accurately targeting the celiac plexus, while minimizing risks to adjacent structures. Historically, celiac plexus neurolysis was performed via instillation of ethanol or phenol; however, within the past decade cryoablation has gained increasing use with potentially fewer side effects.

Keywords: celiac plexus; cryoablation; interventional radiology; malignancy; neurolysis; pain management.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
CT-guided celiac plexus cryoneurolysis in a patient with pancreatic cancer. ( a ) Contrast-enhanced CT demonstrating pancreatic head malignancy (black circle). ( b ) Intraprocedural CT images demonstrate two cryoprobes positioned through a posterior approach in the antecrural position.
Fig. 2
Fig. 2
CT-guided alcohol celiac plexus neurolysis in a patient with metastatic pancreatic cancer. An intraprocedural noncontrast CT image through the celiac plexus demonstrates test injection (prior to alcohol injection) via bilateral 22-gauge Chiba needles of dilute iodinated contrast (small white arrow) with appropriate dispersion in the expected location of the celiac plexus.
Fig. 3
Fig. 3
CT-guided celiac plexus cryoneurolysis in a patient with gastric carcinoma and intractable upper abdominal pain. An intraprocedural noncontrast CT image demonstrating posterior antecrural placement of bilateral cryoablation probes just lateral to the aorta between the celiac axis and SMA origins. The ablation zones (ice balls marked by the small white arrows) are localized to the expected location of the celiac plexus with selective targeting of the nerve bundle at that level.
See this image and copyright information in PMC

References

    1. de Oliveira R, dos Reis M P, Prado W A.The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain Pain 2004110(1-2):400–408. - PubMed
    1. Wong G Y, Schroeder D R, Carns P E. 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(09):1092–1099. - PubMed
    1. Filippiadis D K, Tselikas L, Bazzocchi A, Efthymiou E, Kelekis A, Yevich S. Percutaneous management of cancer pain. Curr Oncol Rep. 2020;22(05):43. - PubMed
    1. Thompson G E, Moore D C, Bridenbaugh L D, Artin R Y. Abdominal pain and alcohol celiac plexus nerve block. Anesth Analg. 1977;56(01):1–5. - PubMed
    1. Loukas M, Klaassen Z, Merbs W, Tubbs R S, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat. 2010;23(05):512–522. - PubMed