Recent Advances in Management of Chronic Pancreatitis

Seon Mee Park

doi:10.4166/kjg.2015.66.3.144

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Park: Recent Advances in Management of Chronic Pancreatitis

Review Article

Korean J Gastroenterol 2015;66(3):144-149.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.66.3.144

Recent Advances in Management of Chronic Pancreatitis

Seon Mee Park

Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea

Correspondence to: Seon Mee Park, Department of Internal Medicine, Chungbuk National University College of Medicine, 1 Chungdae-ro, Seowon-gu, Cheongju 28644, Korea. Tel: +82-43-269-6019, Fax: +82-43-273-3252, E-mail: smpark@chungbuk.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Treatment for chronic pancreatitis (CP) should be started early to prevent further pancreatic fibrosis and managed with a multidisciplinary approach to prevent complications and to maintain a good quality of life. The management strategies of CP can be divided into medical, endoscopic, and surgical treatment. The role of pancreatic enzymes and antioxidants for pain relief is not clearly defined, but their role in maintaining nutritional support by correcting exocrine insufficiency is well established. Endoscopic treatment is applied for resolution of pancreatic or bile duct strictures, clearance of pancreatic duct stones, and pseudocyst drainage. Endosonography-guided celiac plexus or celiac ganglia block for pain relief are known to be safe procedures but evidence for their effectiveness is still lacking. Surgery is commonly recommended when endoscopic therapy fails or there is suspicion of malignancy. New evidence-based guidelines for the management of CP are needed.

Keywords: Pancreatitis, chronic, Enzyme replacement therapy, Antioxidants, Endoscopic retrograde cholangiopancreatography, Endosonography

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Fig. 1.

Step-up approach for management of chronic pancreatitis. ESWL, extracorporeal shock wave lithotripsy; PD, pancreatic duct; BD, bile duct; CPB, celiac plexus block; CGB, celiac ganglia block; SEMS, self-expandable metal stents.

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