Endoscopic therapy for chronic pancreatitis.
Endoscopic therapy is recommended as the first-line therapy for painful chronic pancreatitis with an obstacle on the main pancreatic duct (MPD). The clinical response should be evaluated at 6 to 8 weeks. Calcified stones that obstruct the MPD are first treated by extracorporeal shockwave lithotripsy; dominant MPD strictures are optimally treated with a single, large, plastic stent that should be exchanged within 1 year even in asymptomatic patients. Pancreatic pseudocysts for which therapy is indicated and are within endoscopic reach should be treated by endoscopy.
Division of Gastroenterology and Hepatology, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, Geneva 1211, Switzerland. Electronic address: dumonceau123@yahoo.com.
Jean-Marc
JM
Dumonceau
D002137:Calculi / Q000150:complications / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D004322:Drainage; D019160:Endosonography; D006801:Humans; D008096:Lithotripsy; D009407:Nerve Block; D010183:Pancreatic Ducts / Q000473:pathology* / Q000601:surgery*; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000209:etiology* / Q000628:therapy*; D015607:Stents; D018084:Ultrasonography, Interventional
Celiac plexus block; Chronic pancreatitis; Endoscopic retrograde cholangio-pancreatography; Endoscopic ultrasonography; Extracorporeal shockwave lithotripsy; Guideline; Pain; Treatment