[Gastro-intestinal surgery and gastroenterology. V. Chronic pancreatitis: gastroenterologic aspects]

Chronic pancreatitis causes irreversible damage to the pancreatic parenchyma and ultimately leads to exo- and endocrine insufficiency. In the Western world, alcohol is the main cause of chronic pancreatitis; part of the patients with idiopathic or alcoholic pancreatitis conceivably have a raised sensitivity to the toxic effects of alcohol because of a certain genetic predisposition. The most striking symptom, severe recurrent or persistent pain is often difficult to manage. Various forms of imaging examination provide complementary information on lesions of the pancreatic parenchyma, the pancreatic duct, the bile ducts and adjacent structures; ultrasonoscopy is the technique of first choice in case of suspicion of a pancreatic disorder. Endoscopic therapies are booming: sphincterotomy, calculus extraction, insertion of an endoprosthesis in the pancreatic duct and drainage of pseudocysts (transpapillary or through the jejunum or stomach).