Intraoperative Versus CT Guided Celiac Plexus Neurolysis in Unresectable Pancreatic Cancer

Study Purpose

Many studies had stated that the coeliac plexus neurolysis (CPN) is a safe and effective treatment method of pain associated with pancreatic cancer. The neurolytic injectate is usually alcohol 50-100%; however, phenol >5% is also possible to use. Nowadays, there are several techniques to access the coeliac plexus (per cutaneous using fluoroscopy or computed tomographic imaging (CT), surgical and endoscopic ultrasound). However, the percutaneous computed tomography guided technique is the gold standard technique, it has multiple drawbacks as availability and cost of imaging modality, exposure to radiation and multiple complications.Surgical technique in spite of being easy, cheap but there is a controversy about its efficacy. Also there is no head to head comparison between the surgical technique and the percutaneous technique.In this study we hypothesized that intraoperative technique has the same efficacy of percutaneous celiac block technique with less complication and cost

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.

An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.

Searching Both is inclusive of interventional and observational studies.

Eligible Ages 18 Years - 80 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Adult patients suffering of pain from pancreatic cancer with baseline VAS≥5, scheduled for surgical assessment - patients proven histololgically to be unresectable - patients undergoing either biopsy or bypass surgery

    Exclusion Criteria:

    - patient with resectable tumour will be excluded.
  • - Patient with coagulopathy.
  • - patient with aortic aneurysm.
  • - patient with any disease contraindicating any sympathetic blockade as advanced cardiac disease .

Trial Details

Trial ID:

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Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Mansoura University
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Tarek M. Shams, MDMahmoud M. Elsedeiq, MScMohamed A. Ghanim, MDIbrahim I. Abd El-basir, MD
Principal Investigator Affiliation : Professor of Anesthesia and Surgical Intensive Careassistan lecturer of Anesthesia and Surgical Intensive CareAssistant Professor of Anesthesia and Surgical Intensive CareLecturer of Anesthesia and Surgical Intensive Care
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Overall Status Recruiting
Countries Egypt

The disease, disorder, syndrome, illness, or injury that is being studied.

Pain, Chronic
Additional Details

This study aimed to compare the efficacy of the surgical technique versus the per cutaneous computed tomographic guided technique of celiac plexus neurolysis for pain management in unresectable pancreatic cancer . all patients suffering from pain of pancreatic cancer with VAS≥5 undergoing laparotomy and proved to be unresectable either undergoing biopsy or bypass surgery will receive celiac plexus neurolysis either intraoperative or post operative CT guided . All patients will be managed by systemic analgesic if the block not sufficient . In this study we will give the patient the analgesic according to WHO recommendation as starting by non steroidal anti inflammatory drugs as diclofenac sodium, if it is not sufficient we will give them opioids as tramadol, and for neuropathic pain gabapentin. All drugs will be given with escalating dose . Failed block defined as change in VAS between VAS BASELINE AND ONE MONTH ≤ 3 may need to repeat the block by percutaneous technique .

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International Sites

Mansourah, Dakahlia, Egypt




Mansoura university , gastrointestinal surgery center

Mansourah, Dakahlia,

Site Contact

Mahmoud M. Elsedeiq, MSc

01095378336 #002

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