title: [Guidelines for management of patients with chronic pancreatitis. Report from a consensus conference].
abstract: Chronic pancreatitis has an incidence of 3-8 new cases per 100,000 inhabitants and year. Alcohol is the most common cause. It is, however, not an independent risk factor but rather a co-factor. Smoking and genetic predisposition are increasingly regarded as causative factors. The diagnosis is today based mainly on history and findings at imaging tests. Pain treatment starts with NSAID-medication with or without paracetamol. Oral pancreatic enzyme therapy for pain should be tested early in the course. Endoscopic stent insertion into the main pancreatic duct can be used in selected cases. Operation is not recommended until other less invasive methods have been tested but should ideally be performed before addiction to opiates occurs. Oral enzyme supplementation is effective in the majority of cases with malnutrition. Most patients with chronic pancreatitis and diabetes need insulin treatment. Interdisciplinary specialist treatment teams should be established and take responsibility for diagnosis, assessment and interventional procedures (e.g. endoscopy, surgery). Due to the low incidence of the disease 3-4 such teams/centres seem appropriate in our country to allow a critical patient load.
authors.affiliation: Kirurgiska kliniken, Universitetssjukhuset, Lund. ingemar.ihse@kir.lu.se
authors.forename: Ingemar
authors.initials: I
authors.lastname: Ihse
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
authors.forename: Nils
authors.initials: N
authors.lastname: Albiin
authors.forename: Anders
authors.initials: A
authors.lastname: Borgström
authors.forename: Ake
authors.initials: A
authors.lastname: Danielsson
authors.forename: Lars Erik
authors.initials: LE
authors.lastname: Hammarström
authors.forename: Anders
authors.initials: A
authors.lastname: Kilander
authors.forename: Marianne
authors.initials: M
authors.lastname: Kristiansson
authors.forename: Johan
authors.initials: J
authors.lastname: Permert
authors.forename: Bengt
authors.initials: B
authors.lastname: Sternebring
mesh_terms: D000437:Alcoholism / Q000150:complications; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002908:Chronic Disease; D032921:Consensus; D016145:Endoscopy, Digestive System; D006801:Humans; D009748:Nutrition Disorders / Q000150:complications; D010146:Pain / Q000175:diagnosis / Q000601:surgery; D059408:Pain Management; D010183:Pancreatic Ducts / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D015607:Stents; D013548:Sweden
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
vernacular_title: Riktlinjer för handläggning av patienter med kronisk pankreatit. Rapport från ett konsensusmöte.