Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis.

Abstract:

OBJECTIVES:The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). METHODS:Six important clinical questions were determined regarding EUS-CPN. Following a detailed literature review, 6 statements were proposed attempting to answer those questions. A group of expert endosonographers convened in Chicago, United States (May 2016), where the statements were presented and feedback provided. Subsequently a consensus group of 35 expert endosonographers voted based on their individual level of agreement. A strong recommendation required 80% voter agreement. The modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria were used to rate the strength of recommendations and the quality of evidence. RESULTS:Eighty percent agreement was reached on 5 of 6 consensus statements, 79.4% agreement was reached on the remaining one. CONCLUSIONS:EUS-CPN is efficacious, should be integrated into the management of pancreas cancer pain, and can be considered early at the time of diagnosis of inoperable disease. Techniques may still vary based on operator experience. Serious complications exist, but are rare.

journal_name

Endosc Ultrasound

journal_title

Endoscopic ultrasound

authors

Wyse JM,Battat R,Sun S,Saftoiu A,Siddiqui AA,Leong AT,Arturo Arias BL,Fabbri C,Adler DG,Santo E,Kalaitzakis E,Artifon E,Mishra G,Okasha HH,Poley JW,Guo J,Vila JJ,Lee LS,Sharma M,Bhutani MS,Giovannini M,Kitano M

doi

10.4103/eus.eus_97_17

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

369-375

issue

6

eissn

2303-9027

issn

2226-7190

pii

EndoscUltrasound_2017_6_6_369_220933

journal_volume

6

pub_type

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