Celiac plexus block and neurolysis (CPB/N) is an effective interventional technique for treating chronic upper abdominal pain. Currently, there are various CPB/N techniques, and there is an urgent need to develop an expert consensus to enable clinicians to correctly implement the CPB/N technique, improve efficacy, and reduce complications. A total of 20 medical experts were invited to participate in the writing of this expert consensus, including pain physicians, interventional radiologists, gastroenterologists/endoscopists, and anatomy professors. All experts are from Class A tertiary hospitals affiliated of medical universities in parts of China. Except for the anatomy professors, all experts are engaged in the clinical practice of CPB/N surgery and are familiar with indications, surgical procedures, and complication management. Chinese and English literatures related to CPB/N from January 2008 to October 2025 were retrieved to evaluate the recommendation levels. Each expert made multiple revisions to the initial draft of the expert consensus and voted on the classification levels with significant disagreements. This expert consensus reviews the anatomical characteristics of the celiac plexus, summarizes the indications and contraindications for the clinical implementation of CPB/N, describes in detail the technical methods of CPB/N via different approaches, expounds on the drugs and dosages for CPB and CPN, and depicts the clinical manifestations, management, and prevention of complications. Based on the current domestic practice of CPB/N and literature reports, the recommended grades for CPB/N are proposed. We recommend the posterior retrocrural/antecrural approach under CT guidance and EUS-guided CPB/N technique due to their high success rate and low risk. We do not recommend the approach with potential iatrogenic risks, such as transarterial puncture. The incidence of CPB/N complications is very low, and some complications are temporary. Performing CPB/N under imaging guidance can prevent the occurrence of serious complications such as nerve injury and bleeding.
Wang et al. (2026) studied this question.