Changes in Glycemic Parameters After Celiac Plexus Neurolysis in Patients with Type 2 Diabetes Mellitus: A Retrospective Case Series.

Celiac plexus neurolysis (CPN) ablates the celiac ganglia using dehydrated (99%) ethanol, typically for palliation of upper abdominal pain. The sympathetic nervous system contributes to hepatic glucose production and suppression of insulin secretion, so disruption of these pathways may alter glycemic regulation. Glycemic outcomes are described in 6 patients with Type 2 diabetes mellitus who underwent CPN for chronic abdominal pain over a 9-year period. All 6 procedures were technically successful without 30-day adverse events, and no hypoglycemic episodes occurred during follow-up. At 6 and 12 months, all 6 patients showed reductions in HbA1c (mean change: -1.3% and -1.1%, respectively) and fasting glucose (mean change: -44.0 mg/dL and -52.2 mg/dL, respectively). Of the 4 insulin-treated patients, 2 discontinued insulin entirely and 2 had their insulin dose reduced. These hypothesis-generating findings suggest CPN may have an incidental effect on glycemic control warranting prospective evaluation.