Purpose of Review

Chronic abdominal pain (CAP) is a significant health problem that can dramatically affect quality of life and survival. Pancreatic cancer is recognized as one of the most painful malignancies with 70–80% suffering from substantial pain, often unresponsive to typical medical management. Celiac plexus neurolysis and celiac plexus block (CPB) can be performed to mitigate pain through direct destruction or blockade of visceral afferent nerves. The objective of this manuscript is to provide a comprehensive review of the CPB as it pertains to CAP with a focus on the associated anatomy, indications, techniques, neurolysis/blocking agents, and complications observed in patients who undergo CPB for the treatment of CAP.

Recent Findings

The CAP is difficult to manage due to lack of precision in diagnosis and limited evidence from available treatments. CAP can arise from both benign and malignant causes. Treatment options include pharmacologic, interventional, and biopsychosocial treatments. Opioid therapy is typically utilized for the treatment of CAP; however, opioid therapy is associated with multiple complications. CPB has successfully been used to treat a variety of conditions resulting in CAP. The majority of the literature specifically related to CPB is surrounding chronic pain associated with pancreatic cancer. The literature shows emerging evidence in managing CAP with CPB, specifically in pancreatic cancer.

Summary

This review provides multiple aspects of CAP and CPB, including anatomy, medical necessity, indications, technical considerations, available evidence, and finally complications related to the management.

中文翻译：

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腹腔神经丛阻滞治疗慢性腹痛的综合综述。

审查目的

慢性腹痛（CAP）是一个严重的健康问题，会严重影响生活质量和生存。胰腺癌被认为是最痛苦的恶性肿瘤之一，其中70％至80％患有严重疼痛，通常对典型的药物治疗无反应。可以进行腹腔神经丛神经溶解和腹腔神经丛阻滞（CPB），以通过直接破坏或阻断内脏传入神经来减轻疼痛。本手稿的目的是对与CAP有关的CPB进行全面综述，重点是在接受CPB治疗CAP的患者中观察到的相关解剖结构，适应症，技术，神经溶解/阻断剂和并发症。

最近的发现

由于诊断缺乏精确性以及现有治疗方法的证据有限，CAP难以管理。CAP可能来自良性和恶性原因。治疗选择包括药物治疗，介入治疗和生物心理治疗。阿片类药物疗法通常用于CAP的治疗。然而，阿片类药物治疗与多种并发症相关。CPB已成功用于治疗导致CAP的各种疾病。与CPB特别相关的大多数文献都围绕着与胰腺癌有关的慢性疼痛。文献显示了用CPB管理CAP的新兴证据，特别是在胰腺癌中。

概要

这篇综述提供了CAP和CPB的多个方面，包括解剖结构，医学上的必要性，适应症，技术考虑，可用证据以及最终与治疗相关的并发症。