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Percutaneous Radiofrequency Ablation of the Splanchnic Nerves in Patients with Chronic Pancreatitis: Results of Single and Repeated Procedures in 11 Patients
Author(s) -
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.
Publication year - 2013
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12030
Subject(s) - medicine , percutaneous , splanchnic nerves , radiofrequency ablation , refractory (planetary science) , surgery , pancreatitis , splanchnic , ablation , analgesic , anesthesia , intractable pain , randomized controlled trial , hemodynamics , physics , stimulation , astrobiology
Abstract Background 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. Materials and Methods 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 .Results 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 ( P ≤ 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. Conclusion 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.