title: [Latest advances in chronic pancreatitis].
abstract: This article summarizes some of the recent and clinically relevant advances in chronic pancreatitis. These advances mainly concern the early diagnosis of the disease, the treatment of symptoms and complications, mainly pain and pancreatic exocrine insufficiency, and the diagnosis and therapy of autoimmune pancreatitis. The multimodal dynamic endoscopic ultrasound-guided secretin-stimulated evaluation of the pancreas provides relevant morphological and functional information for the diagnosis of chronic pancreatitis at early stages. Extracorporeal shock wave lithotripsy in patients with calcifying pancreatitis and endoscopic pancreatic stent placement are effective alternatives for pain therapy in patients with chronic pancreatitis. Presence of pancreatic exocrine insufficiency in patients with chronic pancreatitis is associated with a significantly increase of mortality rate. Despite that, pancreatic enzyme replacement therapy is not prescribed in the majority of patients with pancreatic exocrine insufficiency, or it is prescribed at a low dose. The newly developed and commercialized needles for endoscopic ultrasound-guided pancreatic biopsy are effective in retrieving appropriate tissue samples for the histological diagnosis of autoimmune pancreatitis. Maintenance therapy with azathioprine is effective and safe to prevent relapses in patients with autoimmune pancreatitis.
authors.affiliation: Servicio de Aparato Digestivo, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España. Electronic address: enriquedominguezmunoz@hotmail.com.
authors.forename: J Enrique
authors.initials: JE
authors.lastname: Domínguez Muñoz
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis / Q000188:drug therapy; D001639:Bicarbonates / Q000378:metabolism; D042241:Early Diagnosis; D054459:Elasticity Imaging Techniques; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008096:Lithotripsy; D059408:Pain Management; D010179:Pancreas / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D019919:Prosthesis Implantation; D016032:Randomized Controlled Trials as Topic; D012633:Secretin / Q000494:pharmacology; D015607:Stents; D018084:Ultrasonography, Interventional
chemical_list: D001639:Bicarbonates; D007166:Immunosuppressive Agents; D012633:Secretin
keywords: Autoimmune pancreatitis; Ecografía endoscópica; Endoscopic ultrasound; Fine needle aspiration; Insuficiencia pancreática exocrina; Pancreatic exocrine insufficiency; Pancreatic stenting; Pancreatitis autoinmune; Prótesis pancreáticas; Punción-aspiración con aguja fina