ABSTRACT
Disabling pain of many patients with irresectable pancreatic cancer is poorly managed and can remain a significant problem until their deaths. The aim of this study was to evaluate the safety and efficacy of thoracoscopic splanchnicectomy for pain control in patients with irresectable pancreatic cancer. Thirty patients suffering from intractable pain due to irresectable pancreatic cancer underwent 15 attempted thoracoscopic splanchnicectomy procedures. All patients were opiate dependent. Right-sided splanchnicectomy was preformed for a dominantly right-sided pain, whereas a centralized bilateral, or left-sided pain was managed by left splanchnicectomy. If pain recurred, patients were offered to have the procedure repeated on the contralateral side. Thoracoscopic splanchnicectomy procedure was a technical failure because of pleural adhesions in one patient. Fourteen [10 left-and 4 right-sided] thoracoscopic splanchnicectome were successfully completed in 12 patients. Immediate pain relief was achieved in all 12 patients after unilateral thoracoscopic splanchnicectomy. Pain relief persisted till death in 8 patients and till latest postoperative follow-up visit at 5 months in one patients. Two patients required a contralateral procedure for pain recurrence. A third patient had a recurrent pain but refused contralateral intervention. Eoccept the later, non of me patients requiredopioids. Thoracoscopic splanchnicectomy is a safe, simple, and effective minimally invasive procedure. It offers a substantial relief of pain in patients with unresectable pancreatic cancer