Age ≥ 18 years. Confirmed diagnosis of pancreatic, gastric, or hepatobiliary malignancy with epigastric/upper abdominal pain.
Baseline NRS ≥ 7 despite optimized pharmacotherapy, or intolerable opioid side effects.
≥ 50% pain relief on diagnostic splanchnic nerve block. Able to provide informed consent.
You may not be if
Coagulopathy (INR \> 1.5, platelets \< 50,000/µL). Local or systemic infection. Uncontrolled hypotension or severe cardiopulmonary compromise precluding prone positioning.
Intestinal obstruction. Known allergy to contrast, local anesthetic, or the neurolytic agent. Patient refusal.
Clareo Health | Outcomes of Fluoroscopy-Guided Transdiscal Splanchnic Nerve Neurolysis for Upper Abdominal Cancer Pain.
