Percutaneous Radiofrequency Ablation of the Splanchnic Nerves in Patients with Chronic Pancreatitis: Results of Single and Repeated Procedures in 11 Patients. Issue 8 (10th January 2013)

• Record Type: Journal Article
• Authors: Verhaegh, Bas P.M.; van Kleef, Maarten; Geurts, José W.; Puylaert, Martine; van Zundert, Jan; Kessels, Alphons G.H.; Masclee, Ad A.M.; Keulemans, Yolande C.A.
• Is Part Of: Pain practice. Volume 13:Issue 8(2013)
• Page Start: 621
• Page End: 626
• Publication Date: 2013-01-10
• Subjects: Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12030
• Languages: English
• ISSNs: 1530-7085

Abstract

<abstract abstract-type="main" xml:lang="en" id="papr12030-abs-0001"> <title>Abstract</title> <sec id="papr12030-sec-0001" sec-type="section"> <title>Background</title> <p>Pain is a major problem for chronic pancreatitis (CP) patients. Unfortunately, medical therapy often fails. Endoscopic and surgical treatments are invasive, and results vary. Percutaneous radiofrequency ablation of the splanchnic nerves (RFSN) is a relatively new and minimally invasive procedure for treatment of intractable pain in CP patients.</p> </sec> <sec id="papr12030-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>We retrospectively evaluated 18 RFSN procedures in 11 CP patients, all refractory to analgesics. Five patients underwent a second procedure; two patients underwent a third procedure. NRS pain scores were assessed. Complications, analgesics usage, and length of the pain‐free period were recorded<underline>.</underline></p> </sec> <sec id="papr12030-sec-0003" sec-type="section"> <title>Results</title> <p>Radiofrequency ablation of the splanchnic nerves was effective in 15/18 interventions. The mean NRS pain score decreased from 7.7 ± 1.0 to 2.8 ± 2.7 (<italic>P </italic>≤<italic> </italic>0.001). The pain‐free period lasted for a median period of 45 weeks. The effect of repeated interventions was comparable to the initial procedure. One transient side effect was reported. Four patients reported significantly reduced analgesic usage; 4 patients completely stopped their pain medication.</p> </sec> <sec id="papr12030-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Radiofrequency ablation of the splanchnic nerves is a minimally invasive, effective procedure for pain relief. After the effect has subsided, RFSN can be successfully repeated. RFSN might become an alternative treatment in a selected group of CP patients. A larger, randomized trial is justified to substantiate these findings.</p> </sec> </abstract>