Thoracoscopic Left Splanchnicectomy - Role in Pain Control in Unresectable Pancreatic Cancer. Initial Experience

Background: The management of opiate-dependent intractableabdominal pain caused by unresectable pancreatic cancerremains challenging. The aim of this study was to evaluate thesafety and efficacy of thoracoscopic unilateral left splanchnicectomyfor pain control in a first series of 15 patients withunresectable pancreatic cancer.Patients and Methods: Fifteen patients suffering from intractablepain due to unresectable pancreatic cancer (stage III and IV)underwent thoracoscopic unilateral left splanchnicectomy. Toassess pain severity and the impact of this palliative procedurefor pain relief, all patients completed Wong-Baker Faces PainRating Scale with a preoperative pain degree between 7 and 9.Results: Surgical intervention duration varied from 30 minutesto 1 hour. Pleural drainage tube was removed 24 hours postoperatively.There were no complications nor deaths.Immediate pain relief (pain degree 0-2) was achieved in allpatients after thoracoscopic unilateral splanchnicectomy, samelevel being registered at first check-up after one month.Conclusions: Thoracoscopic unilateral left splanchnicectomydecreases the pain substantially and significantly improvesthe quality of life in patients with unresectable pancreaticcancer.

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