[The role of endoscopic treatment of complications of chronic pancreatitis].
This review outlines the indications and results of endoscopic management in the complications of chronic pancreatitis. Symptomatic obstructions of the main pancreatic duct can be treated by endocanalar prosthesis in case of fibrous stenosis and by extracorporeal shock wave lithotripsy in case of intraductal obstructive stones. Symptomatic or large pseudocysts have to be treated and may be treated by placement of transgastric or transduodenal endoprosthesis for pseudocysts protuding into the digestive tract and by using transpapillary endoprosthesis for communicating pseudocysts. Endoscopic treatment of ductal disruptions is difficult and generally requires combined techniques. Symptomatic biliary stenosis can be temporary treated using biliary endoprothesis. Short and long term results and complications of these different procedures are analysed. In the absence of controlled studies, the role of endoscopic treatment in comparison to surgical treatment is not well defined. Present indications for either approach can be discussed on an individual basis.
Service de gastroentérologie, hôpital Beaujon, Clichy, France.
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Ponsot
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Ruszniewski
D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery; D002779:Cholestasis / Q000209:etiology / Q000601:surgery; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery*; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications*