Prospective Study on Endoscopic Ultrasound (EUS) Celiac Bloc Efficacy in Chronic Pancreatitis
Prospective Study on Endoscopic Ultrasound (EUS) Celiac Bloc Efficacy in Chronic Pancreatitis
The purpose of this study is to determine if celiac bloc (with injection of steroid and local
 anesthetic) is superior to a sham procedure for pain control and quality of life improvement
 in patient with chronic pancreatitis and abdominal pain.
Chronic pancreatitis is a condition that can lead to very disabling pain symptoms that are
 difficult to control. The use of morphine is often necessary and also induces a series of
 secondary symptoms.

 In this context, the injection into the celiac plexus block of a local anesthetic has often
 been proposed as an alternative. This procedure, by interrupting the afferent pain signal of
 pancreatic origin, aims to reduce pain and improve quality of life at the cost of fewer side
 effects.

 This procedure can be performed transcutaneously using the anatomical landmark or under
 radiological control. It can also be performed via endosonography (EUS) with better control
 of the injection site under ultrasound control.

 The results of the literature concerning the efficacy of the celiac block in chronic
 pancreatitis are rather encouraging with reported figures of partial or complete pain control
 in 39 to 65% of patients [1-7].

 However, the number of prospective studies concerning this technique performed endoscopically
 remains low to date. In particular, there are no case control studies. Data is also poor on
 the impact on quality of life.

 The study proposed here will therefore attempt to provide answers to the questions still
 pending: is the block by EUS superior to a diagnostic EUS without treatment? ; how long does
 this treatment last? ; does it have an impact on the quality of life of patients? This study
 and its draft are inspired by a similar recent study conducted in our department on patients
 with pancreatic neoplasia. The results of the latter are being submitted for publication.
Inclusion Criteria:

 -  abdominal pain compatible with pancreatic ethiology since at least 3 months

 -  chronic pancreatitis on Computed Tomography (CT), Endoscopic Retrograde
 Cholangiopancreatography (ERCP) or EUS

 -  EUS feasible

 -  inform consent

 Exclusion Criteria:

 -  pregnant women

 -  allergy to local anesthetic

 -  acute pancreatitis in the last 2 weeks

 -  suspicious lesion on pancreatic EUS examination

 -  celiac bloc in the last 3 months