Applications of Celiac Plexus Block in Chronic Pancreatitis or Pancreatic Cancer.

PURPOSE OF REVIEW: Celiac plexus block (CPB) is an established interventional technique for the management of severe upper abdominal pain, particularly in patients with chronic pancreatitis (CP) and pancreatic cancer (PC). Pain in these conditions is complex, involving visceral and neuropathic mechanisms and, in CP, additional contributions from neuropathic remodeling, central sensitization, and altered descending modulation play a role.

RECENT FINDINGS: CPB provides targeted neural blockade to disrupt nociceptive transmission from the upper abdominal viscera, thereby improving analgesia, reducing opioid requirements, and enhancing quality of life. This chapter emphasizes the role of CPB in treating pain resulting from CP and PC, with a specific focus on therapeutic timing, procedural approaches, technical considerations, efficacy, durability of pain relief, side effects, and recent advances. Current evidence suggests that CPB is highly effective in PC pain but provides only modest and short-lived benefit in CP, where it should be reserved for carefully selected refractory cases. Future directions include advanced imaging modalities, improved neurolytic agents, and integration of CPB into multimodal, mechanism-based strategies for comprehensive pain control.