[Treatment of pain in chronic pancreatitis by an endoscopic method].
The epigastric pain is the most frequent manifestation in chronic pancreatitis. It is due to intraductal pancreatic pressure, presence of compressive pseudocysts and probably to neuroinflammatory process caused by alcohol.


OBJECTIVE
The aim of our study was to assess the influence of endoscopic treatment on pain in chronic pancreatitis and the correlation between residual pain after endoscopic treatment and pancreatic morphology.


METHODS
Forty-four patients from the Gastroenterology Department of Angers (France) with chronic pancreatitis were included in our retrospective clinical study. Thirty-seven patients underwent a diagnostic ERCP and only 28 needed an endoscopic treatment. The pain was evaluated semi-quantitatively before and after the endoscopic treatment. The mean follow-up was 28.6 months.


RESULTS
Among the 28 patients with endoscopic treatment, 18 had a complete improvement of the pain, 4 an incomplete improvement and 6 had no improvement; these last were submitted to pancreatic surgery. The pain evolution had a good correlation with the reduction of Wirsung diameter; there was no correlation with ductal stenosis, residual lithiasis and pseudocysts presence. Alcohol consumption had no influence on the pain evolution.


CONCLUSIONS
The endoscopic treatment of intraductal lithiasis and pseudocysts is a useful method for Wirsung decompression, improving the pain in chronic pancreatitis.
Seicean
Andrada
A
Clinique Médicale III, Str. Croitorilor no. 19-21, 3400 Cluj-Napoca, Romania.
Burtin
Pascal
P
Boyer
Jean
J
Pascu
Oliviu
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D019299:Decompression, Surgical; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D020347:Lithiasis / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010183:Pancreatic Ducts; D010192:Pancreatic Pseudocyst / Q000150:complications; D010195:Pancreatitis / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome