[Endoscopic assay and surgery at chronic pancreatitis]

Area of Science:

• Gastroenterology
• Surgical Endoscopy
• Pancreatology

Background:

• Painful chronic pancreatitis often involves major duodenal papilla pathology.
• Accurate diagnosis and effective treatment are crucial for managing patient symptoms.
• Endoscopic interventions offer a less invasive approach compared to traditional surgery.

Purpose of the Study:

• To evaluate the efficacy of endoscopic surgeries for major duodenal papilla pathology in painful chronic pancreatitis.
• To assess the diagnostic capabilities of ERCPG compared to ultrasound for papilla stenosis.
• To determine the outcomes and complication rates of endoscopic papilla interventions.

Main Methods:

• Retrospective analysis of 35 patients with painful chronic pancreatitis.
• Procedures included Endoscopic Retrograde Cholangiopancreatography (ERCPG), Endoscopic Papillotomy (EPST), duct dissections, drainage, and stenting.
• Comparison of ERCPG findings with ultrasonic examination for papilla pathology.

Main Results:

• ERCPG identified major duodenal papilla pathology (stenosis) in 71% of patients, significantly higher than ultrasound (20%).
• Endoscopic papilla interventions (EPST, dissection, drainage, stenting) were performed on 20 patients.
• Immediate pain relief was achieved in 75% of patients undergoing endoscopic surgery, with 70% showing sustained improvement during follow-up (2 months to 3 years).

Conclusions:

• ERCPG is a highly informative and relatively safe diagnostic tool for identifying papilla stenosis in chronic pancreatitis.
• Endoscopic papilla surgeries provide significant and immediate pain relief for a majority of patients.
• Endoscopic interventions represent a viable and effective treatment option for selected patients with painful chronic pancreatitis.