Efficacy and Safety of Celiac Plexus Block in Chronic Pancreatitis: A Multicenter Cohort Study

Objectives: Celiac plexus block (CPB) is used for pain management in chronic pancreatitis (CP), but real-world evidence is limited. This study evaluated clinical outcomes, safety, and utilization trends of CPB in CP. Methods: We conducted a retrospective cohort study using the TriNetX Research Network. Adults with CP were identified; those with pancreatic malignancy or prior pancreatic surgery were excluded. CP patients who underwent CPB were compared with those without CPB. Propensity score matching (1:1) balanced demographics and comorbidities. Primary outcomes were prevalence of opioid prescriptions and emergency department (ED) or hospital encounters at 1, 3, 6, and 12 months. Secondary outcomes included 30-day adverse events and utilization trends. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Results: Among 2,492 CPB recipients and 138,148 controls, 2,443 matched pairs were analyzed. Opioid use was similar at 1 month (HR = 0.995; 95% CI 0.91–1.08) but higher among CPB recipients at 3 months (HR = 1.10; 95% CI 1.02–1.19), 6 months (HR = 1.18; 95% CI 1.10–1.27), and 12 months (HR = 1.21; 95% CI 1.13–1.29). CPB reduced hospital encounters at 1 month (HR 0.79; 95% CI 0.71–0.88) and 3 months (HR 0.90; 95% CI 0.82–0.98), with no difference thereafter. Adverse events were infrequent: hypotension (1.6%), diarrhea (3.1%). CPB utilization rose 2.4-fold from 2015–2024. Conclusions: While CPB appears to reduce hospital encounters, opioid use increased over long-term follow-up, suggesting that its analgesic effect is short-lived. A randomized controlled trial is underway to determine the true efficacy of CPB in CP.