Pain in chronic pancreatitis and pancreatic cancer – treatment options

Czech version

Authors: Martina Bojková ¹; Pavel Klvaňa ¹; Pavel Svoboda ¹; Tomáš Kupka ¹; Arnošt Martínek ¹; Marian Bojko ²; Petr Dítě ¹
Authors‘ workplace: Katedra interních oborů LF OU a Interní klinika FN Ostrava, přednosta doc. MUDr. Arnošt Martínek, CSc. ¹; Katedra hydromechaniky a hydraulických zařízení, Fakulta strojní, VŠB – Technická univerzita Ostrava, vedoucí katedry doc. Dr. Ing. Lumír Hružík ²
Published in: Vnitř Lék 2014; 60(3): 205-211
Category: Reviews

Overview

Treatment of pain is one of the main pillars of treatment of pancreatic diseases. Abdominal pain is a common and often debilitating symptom in patients with chronic pancreatitis and pancreatic cancer. Treatment involves abstinence from tobacco, alcohol and analgetics and adjunctive agents. Surgical and endoscopic treatment requires careful patient selection based on a detailed analysis of ductal anatomy. The limited possibilities of this therapy are patients without dilatation of the main pancreatic duct. Results of randomized trials suggest that the effect of surgical treatment is sustained over time and more efficient than the endoscopic treatment. Less frequently used options include EUS – assisted celiac plexus blockade, thoracoscopic splanchniectomia or total pancreatectomy with islet cell autotransplantation. These methods are rarely used when all other options have failed and only in carefully selected patients.

Key words:
abdominal pain – medical therapy – endoscopy – neurolysis – nociceptive neurons – surgery

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