Opioid use determines success of videothoracoscopic splanchnicectomy in chronic pancreatic pain patients

Stefaniak, Tomasz; Vingerhoets, A.J.J.M.; Makarewicz, Wojciech; Kaska, Łukasz; Kwiecińska, Barbara; Stanek, A; Łachiński, Andrzej J.; Śledziński, Zbigniew

doi:10.1007/s00423-007-0177-2

Cited by 14 publications

(7 citation statements)

References 32 publications

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“…Quality of life was assessed using the well-validated EORTC quality of life questionnaire QLQ C-30, which was adapted for chronic pancreatitis in Polish conditions (Stefaniak et al 2008). The questionnaire consists of 30 questions, and it is divided into two parts.…”

Section: Methodsmentioning

confidence: 99%

“…Considerably, aggressive conservative treatment with eager use of opioids may further lead to diminishing of quality of life of the patients, predominantly in the aspects of social life and everyday functioning (Ruetsch 2010). That fact should be carefully considered in light of the long-term survival of CP patients (Stefaniak et al 2008) and subsequently, the necessity for long-term opioid therapy and increased risk of iatrogenic opioid addiction (Nishimori et al 2006; Ruetsch 2010). Therefore, apart from conservative pain treatment utilised in chronic pancreatitis, special attention must be given to invasive methods like neurolytic celiac plexus block (NCPB), and thoracoscopic splanchnicectomy (TS) that provide a chance for reduction of intensity of conservative treatment and/or prolonging the effectiveness of the drugs instituted and prevention of fast drug dose escalation (Basinski et al 2005; Stefaniak et al 2005).…”

Section: Introductionmentioning

confidence: 99%

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Influence of Religiosity on the Quality of Life and on Pain Intensity in Chronic Pancreatitis Patients After Neurolytic Celiac Plexus Block: Case-Controlled Study

et al. 2011

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The quality of life in patients with chronic pancreatitis (CP) is reduced due to their suffering of high levels of pain. It has been presented that quality of life can also be linked to religiosity and/or spirituality. The aim of this study is to assess the influence of religious practices on the quality of life and on the subjective level of pain in CP patients. Ninety-two patients (37 women and 55 men) with chronic pancreatitis were treated invasively for pain with neurolytic celiac plexus block (NCPB). The religiosity of the patients was recorded and served as a dichotomizer. Group 1 was for patients who claimed to have no contact with the church or to have very sporadic contact (N = 35 patients). Group 2 was for patients who claimed to have deep faith and were regular participants at church activities (N = 57 patients). Visual analogue scale was used to assess pain, while the quality of life was measured by using QLQ C-30 questionnaire adapted for chronic pancreatitis patients in Polish population. The patients were assessed prior to the pain-relieving intervention and subsequently 2 and 8 weeks after it. The intensity of pain was reduced in both groups significantly after performing the NCPB. Patients who declared a deep faith reported higher level of pain on the VAS scale prior to intervention than non-religious patients. Quality of life in both groups of patients significantly improved after NCPB. Following NCPB, global quality of life in patients who declared higher religiosity/church attendance was significantly higher (79.88) than for those patients who have no contact or sporadic contact with the church (44.21, P < 0.05). NCPB resulted in significant reduction of pain and increase in quality of life in both groups of patients with CP. Nevertheless, in the group declaring higher religiosity/church attendance, reported pain was higher, but, despite that, quality of life better. It may be concluded that religious practices might serve as an additional factor improving quality of life and coping in patients suffering from chronic pancreatitis.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of Religiosity on the Quality of Life and on Pain Intensity in Chronic Pancreatitis Patients After Neurolytic Celiac Plexus Block: Case-Controlled Study

et al. 2011

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“…Alternative procedure in the management of pain in unresectable pancreatic cancer as well as in other upper abdominal pain syndromes is TS. This method has been previously described by many authors, and its main assumption is to remove splanchnic nerves, that conduct the pain impulses from the pancreas to the central nervous system . The procedure is usually performed bilaterally during the same surgery, with prone positioning of the patient and tracheal intubation.…”

Section: Thoracoscopic Splanchnicectomymentioning

confidence: 99%

“…Among the complication and side effects after splanchnicectomy, primarily intercostal neuralgia that can occur in almost every fourth patient should be mentioned . Other complications that occur in <2% of the patients are pulmonary atelectasis, chylothorax and orthostatic hypotension . Therefore, the frequency of complications can be considered low and the procedure can be considered safe and feasible …”

Section: Thoracoscopic Splanchnicectomymentioning

confidence: 99%

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Pain in pancreatic cancer: review of medical and surgical remedies

Dobosz

Kaczor

Stefaniak

2016

ANZ Journal of Surgery

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Pancreatic cancer is a malignant tumour with very poor prognosis and a chance for 5-year survival is approximately 6%. One of the main symptoms of this neoplasm is pain, mostly of neuropathic origin, which significantly decreases the quality of life and impairs the functional activity of patients. The most common treatment of pain in pancreatic cancer is conservative therapy which is based on analgesic ladder rules established by the World Health Organization. Unfortunately, it is not always effective and it has many side effects that also can diminish patients' quality of life. Invasive treatment of pain in pancreatic cancer includes mainly coeliac plexus block and sympathectomy, and both of them significantly reduce levels of pain and help to improve the quality of life. It is postulated that the place of those two invasive methods should not be at the final stage of treatment, but they can provide significantly better improvement of pain once instituted earlier (such as the first or second step of analgesic World Health Organization's ladder). The aim of this article is to review and assess the conservative as well as the invasive therapy in the management of pain in pancreatic cancer. It also presents brief insight into non-medical methods of pain reduction, which can be supplementary to conservative and/or invasive treatment.

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Chronic Pancreatitis

Mössner¹,

Hoffmeister²,

Mayerle³

2015

Yamada' S Textbook of Gastroenterology

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Opioid use determines success of videothoracoscopic splanchnicectomy in chronic pancreatic pain patients

Abstract: When planning the VSPL in the treatment of pain in patients suffering from chronic pancreatitis, it is necessary to take into consideration the previous chronic use of opioids, as this variable can significantly influence poorer results of this surgical pain management.

Cited by 14 publications

References 32 publications

Influence of Religiosity on the Quality of Life and on Pain Intensity in Chronic Pancreatitis Patients After Neurolytic Celiac Plexus Block: Case-Controlled Study

Influence of Religiosity on the Quality of Life and on Pain Intensity in Chronic Pancreatitis Patients After Neurolytic Celiac Plexus Block: Case-Controlled Study

Pain in pancreatic cancer: review of medical and surgical remedies

Chronic Pancreatitis

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