Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol
Article
Behbahani, K, Chary, A, Patel, S et al. (2020). Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol
. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 31(8), 1216-1220. 10.1016/j.jvir.2020.04.008
Behbahani, K, Chary, A, Patel, S et al. (2020). Percutaneous CT-Guided Cryoablation of the Celiac Plexus: A Retrospective Cohort Comparison with Ethanol
. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 31(8), 1216-1220. 10.1016/j.jvir.2020.04.008
Purpose: To retrospectively analyze and compare the incidence of diarrhea in patients who underwent cryoablation of the celiac plexus for intractable abdominal pain versus ethanol therapy over a 5-year period. Materials and Methods: From June 2014 to August 2019, 83 patients were identified who underwent neurolysis of the celiac plexus for management of intractable abdominal pain by using either cryoablation (n = 39 [59% female; age range, 36–79 years old [average, 60 ± 11 years old]) or alcohol (n = 44 [48% female; age range, 29–76 years old [average, 60 ± 12 years old]). Pain scores and reports of procedure-related complications or side effects, with special attention to diarrhea and/or other gastrointestinal symptoms, were collected from follow-up visits at 1 week, 1 month, and 3 months post-intervention and were compared between groups. Results: The mean time of follow-up was 17.7 days. Four patients who underwent cryoablation developed gastrointestinal symptoms consisting of 2 cases of nausea and vomiting and 2 cases of diarrhea (5.1%). Twelve patients who underwent ethanol ablation developed gastrointestinal symptoms, including 1 case of nausea, 3 cases of vomiting, and 9 cases of diarrhea (20.5%). There was a significantly higher incidence of both diarrhea (chi-squared likelihood ratio, P =.03) and overall gastrointestinal symptoms (chi-squared likelihood ratio, P =.04) in the ethanol group than in the cryoablation group. Conclusions: Cryoablation of the celiac plexus may provide a new treatment option for intractable abdominal pain, and it appears to have a lower incidence of diarrhea and fewer gastrointestinal side effects than ablation using ethanol.
