• Gil Ascunce, Afonso Ribeiro, Isildinha Reis, Caio Rocha-Lima, Danny Sleeman, Jaime Merchan, and Joe Levi.
• Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
• Gastrointest. Endosc. 2011 Feb 1;73(2):267-74.

BackgroundEUS-guided celiac plexus neurolysis (EUS-CPN) improves pain control in patients with pancreatic cancer. EUS allows visualization of the celiac ganglion.ObjectiveTo determine predictors of response to EUS-CPN in a cohort of 64 patients with pancreatic malignancy.DesignRetrospective analysis of prospective database.SettingAcademic medical center.PatientsSixty-four patients with pancreatic cancer referred for EUS between March 2008 and January 2010.InterventionsEUS-CPN injected directly into celiac ganglia when visible by linear EUS or bilateral injection at the celiac vascular trunk.Main Outcome MeasurementsPredictors of pain improvement at week 1 by univariate and multivariate analysis.ResultsAt week 1, 32 patients (50%) had a symptomatic response. In a multivariate model with 8 potential predictors, visualization of the ganglia was the best predictor of response; patients with visible ganglia were >15 times more likely to respond (odds ratio 15.7; P<.001). Tumors located outside the head of the pancreas and patients with a higher baseline pain level were weakly associated with a good response.LimitationsRetrospective design and lack of blinding.ConclusionsVisualization of celiac ganglia with direct injection is the best predictor of response to EUS-CPN in patients with pancreatic malignancy.Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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