Optimising palliative care: the role of early splanchnic nerve block in advanced hepatobiliary cancer.

Patients with inoperable hepatobiliary cancers often endure severe abdominal pain, which impacts their quality of life. This pain is usually a combination of both nociceptive and neuropathic pain, which necessitates a comprehensive multimodal approach for effective management. Splanchnic nerve plexus block (SNB) has shown promising results in this regard. This case series reviews the literature and clinical practices, exploring the potential benefits of early SNB in the palliative care of patients with hepatobiliary cancers. We describe three cases illustrating SNB's potential in achieving notable pain relief. Each patient reported a pain reduction from 10/10 to less than 1/10, a reduced requirement for opioids and sustained relief at a 1-month follow-up. This case series suggests the potential role of SNB in select patients with ongoing oncology therapy for alleviating severe pain, decreasing opioid requirements and potentially enhancing overall functional status.