[Endoscopic and surgical treatment of chronic pancreatitis]

Therapeutic management of patients with chronic pancreatitis is a multidisciplinary approach. Although interventional endoscopy and external lithotripsy have an important role to play, surgery keeps a prominent position in the therapeutic armentarium. The progress in radiology and endoscopy, the possibility of a preliminary therapeutic approach by a nonsurgical therapy have led to precise guidelines in the management. Surgery is indicated not only for rescue when endoscopic treatment is unsuccessful, but also as a one step procedure when failure of nonsurgical therapy can be anticipated right away. A key point is that nonsurgical and surgical therapeutic modalities are now complementary instead of being competitive.