Endotherapy for pain in chronic pancreatitis.
Pain is the most distressing symptom of chronic pancreatitis. Although the pathogenesis of pain is still poorly understood, an increase in intraductal pressure may be the dominant factor. The management of pain can involve medical, endoscopic, neurolytic, and surgical therapies. Endotherapy includes pancreatic sphincterotomy, extraction of stones, placement of stent, and dilatation of strictures, sometimes preceded or followed by extracorporeal shock-wave lithotripsy. Several studies have now shown that endotherapy provides partial or complete relief of pancreatic pain in a majority of patients with an acceptable frequency of early and late complications. Endotherapy should now graduate from an experimental form of treatment to a realistic treatment option in patients with chronic or relapsing pain, particularly in the setting of calcific chronic pancreatitis.
Khanna
Sudeep
S
Department of Gastroenterology, Pushpawati Singhania Reasearch Institute for Liver, Renal & Digestive Diseases, New Delhi, India.
Tandon
Rakesh K
RK
D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008096:Lithotripsy; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D010179:Pancreas / Q000000981:diagnostic imaging / Q000503:physiopathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011312:Pressure; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome