Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2025
Endoscopic ultrasound-guided celiac plexus block for painful chronic pancreatitis: A systematic review and meta-analysis.
Систематический обзорСтатьяМетаанализНазвание и аннотация: Перевод в очереди
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Machicado Jorge D, Tanner Samuel, Adoor Dayyan, Chalhoub Jean M, Plann-Curley Brendan, Lee Un Jung, Bang Ji Young, Varadarajulu Shyam, Wilcox C Mel, US Pancreatic Disease Study Group
Аннотация
BACKGROUND: The efficacy of endoscopic ultrasound-guided celiac plexus block (EUS-CPB) for treatment of pain in chronic pancreatitis (CP) is unclear. Therefore, we aimed to assess this outcome using a systematic review and meta-analysis.
METHODS: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane Central for evaluating the efficacy of EUS-CPB for pain in CP. We evaluated: A) overall efficacy of EUS-CPB (defined as proportion of patients with any pain relief); B) duration of pain relief; C) efficacy of EUS-CPB at 4, 8, 12, and 26 weeks post-procedurally; and D) adverse events. A proportional meta-analysis was performed using the logit transformation. Outcomes were pooled using a random-effects model.
RESULTS: 11 studies encompassing 729 patients met inclusion and exclusion criteria. The overall efficacy of EUS-CPB was 53% (95% CI 39-67%, I2 = 91%). The mean duration of pain relief was 81 days (95% CI 30-217, I2 = 96%). The efficacy of EUS-CPB at 4 weeks was 52% (95% CI 22-81%, I2 = 90%), at 8 weeks was 57% (95% CI 48-66%, I2 = 0%), at 12 weeks was 19% (95% CI 12-27%, I2 = 68%), and at 26 weeks was 3% (95% CI 1-8%, I2 = 0%). The prevalence of adverse events was 8% (95% CI 4-15%, I2 = 67%).
CONCLUSIONS: EUS-CPB provides pain relief in 53% of patients with painful CP and the effect lasts on average for 3 months. A sham-controlled clinical trial is needed to determine the analgesic efficacy of EUS-CPB for pain in CP.
METHODS: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane Central for evaluating the efficacy of EUS-CPB for pain in CP. We evaluated: A) overall efficacy of EUS-CPB (defined as proportion of patients with any pain relief); B) duration of pain relief; C) efficacy of EUS-CPB at 4, 8, 12, and 26 weeks post-procedurally; and D) adverse events. A proportional meta-analysis was performed using the logit transformation. Outcomes were pooled using a random-effects model.
RESULTS: 11 studies encompassing 729 patients met inclusion and exclusion criteria. The overall efficacy of EUS-CPB was 53% (95% CI 39-67%, I2 = 91%). The mean duration of pain relief was 81 days (95% CI 30-217, I2 = 96%). The efficacy of EUS-CPB at 4 weeks was 52% (95% CI 22-81%, I2 = 90%), at 8 weeks was 57% (95% CI 48-66%, I2 = 0%), at 12 weeks was 19% (95% CI 12-27%, I2 = 68%), and at 26 weeks was 3% (95% CI 1-8%, I2 = 0%). The prevalence of adverse events was 8% (95% CI 4-15%, I2 = 67%).
CONCLUSIONS: EUS-CPB provides pain relief in 53% of patients with painful CP and the effect lasts on average for 3 months. A sham-controlled clinical trial is needed to determine the analgesic efficacy of EUS-CPB for pain in CP.