Introduction: Pain from cancer liver is considered as one of the most annoying side effects of invasive malignancy. The celiac ganglion in the upper abdomen is an important anatomic structure in the pathway of pain from upper abdominal visceral malignancies. Neurolysis is done by absolute alcohol.
Methods: In our study started from 1st June 2014 and lasted for a year we treated twenty cases suffered from intractable pain resistant to traditional analgesic medication from advanced hepatic malignancy. In all patients we performed CT guided celiac neurolysis by injecting cocktail of absolute alcohol, lidocaine and iodinated contrast agent, with a ratio of 6:3:1. In fourteen cases we used the unilateral approach, in ten patients of them we used the retrocrural approach and in the other four cases we had chosen the unilateral antecrural approach. Bilateral approach was performed in six cases, four of them by retrocrural approach and two by antecrural approach.
Results: Pain was relieved completely in two patients from bilateral retrocrural approach group, in two cases from bilateral retrocrural approach group in addition to patients from bilateral antecrural and unilateral retrocrural approach groups there is a good response with relief of symptoms and lowering of the analgesic dose by more than 50%. In the Unilateral antecrural group two cases show no response with the other two cases show mild response with lowering of the overall dose of analgesic by less than 50%.
Conclusion: CT guided neurolysis of the celiac ganglion is an effective treatment method for intractable pain from advanced cancer liver