Korean J Gastroenterol.  2015 Sep;66(3):144-149. 10.4166/kjg.2015.66.3.144.

Recent Advances in Management of Chronic Pancreatitis

• Park SM

• KMID: 2373329
• DOI: http://doi.org/10.4166/kjg.2015.66.3.144

Abstract

Treatment for chronic pancreatitis (CP) should be started early to prevent further pancreatic fibrosis and managed with a multidisciplinary approach to prevent complications and to maintain a good quality of life. The management strategies of CP can be divided into medical, endoscopic, and surgical treatment. The role of pancreatic enzymes and antioxidants for pain relief is not clearly defined, but their role in maintaining nutritional support by correcting exocrine insufficiency is well established. Endoscopic treatment is applied for resolution of pancreatic or bile duct strictures, clearance of pancreatic duct stones, and pseudocyst drainage. Endosonography-guided celiac plexus or celiac ganglia block for pain relief are known to be safe procedures but evidence for their effectiveness is still lacking. Surgery is commonly recommended when endoscopic therapy fails or there is suspicion of malignancy. New evidence-based guidelines for the management of CP are needed.

Keyword

Pancreatitis, chronic; Enzyme replacement therapy; Antioxidants; Endoscopic retrograde cholangiopancreatography; Endosonography

MeSH Terms

Antioxidants/therapeutic use
Cholangiopancreatography, Endoscopic Retrograde
Endosonography
Enzyme Replacement Therapy
Fibrosis
Gallstones/therapy
Humans
Lithotripsy
Pancreas/pathology
Pancreatitis, Chronic/*drug therapy/pathology
Antioxidants

Figure

• 

  Fig. 1. Step-up approach for management of chronic pancreatitis. ESWL, extracorporeal shock wave lithotripsy; PD, pancreatic duct; BD, bile duct; CPB, celiac plexus block; CGB, celiac ganglia block; SEMS, self-expandable metal stents.

Reference

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