[Value of endoscopy in the treatment of chronic pancreatitis].
Endoscopic treatment in patients with chronic pancreatitis involves several features: sphincterotomy of the wirsung, dilatation, insertion of a prosthesis, cystoenterostomy, cystowirsungostomy. Extracorporal lithotrity is often associated. Endoscopic treatment appears to give satisfactory short-term results in cases with pain, pseudocyst or pancreatic fistula. Morbidity is low. The optimum duration of endoscopic drainage via the prosthesis is still a question of debate and the long-term efficacy remains to be demonstrated. Endoscopic treatment is indicated in patients with a definitive or temporary surgical risk or may be indicated for all symptomatic patients. In this case, endoscopic treatment would be used as a therapeutic test. Stenosis of the main bile duct is not at present a good indication for endoscopic treatment as this stenosis is resistant to balloon dilatation and prosthesis calibration.
Ponchon
T
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Fédération des Spécialités Digestives, Hôpital E. Herriot, Lyon.
D002908:Chronic Disease; D016145:Endoscopy, Digestive System; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D010183:Pancreatic Ducts / Q000601:surgery; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D016717:Sphincterotomy, Endoscopic