[Endoscopic diagnosis of chronic pancreatitis]

Endoscopy entered the diagnosis of pancreatic diseases in 1972 as the first endoscopic retrograde cholangiopancreaticography and during subsequent decades it markedly extended its field of action to comprise also endoscopic therapy of the pancreas. At present it represents together with abdominal sonography, computed tomography, endosonography, and nuclear magnetic resonance the basic spectrum of morphological examination methods of the pancreas. The disadvantage of endoscopic retrograde cholangiopancreaticography is the invasive character of this method associated with complications. In chronic pancreatitis this method can be used in particular to evaluate the extent of morphological changes--i.e. classification of chronic pancreatitis, whereby the most frequently used one is the Cambridge classification. The method, contrary to other morphological imaging methods can diagnose variants and malformations of the pancreatic efferent system, it cannot however, with the exception of chronic obstructive pancreatitis and chronic pancreatitis in pancreas divisum detect the cause of chronic pancreatitis and is also of very limited informative value in the differential diagnosis of chronic pancreatitis and carcinoma of the pancreas. Endoscopic retrograde pancreaticography cannot be implemented after some surgical operations of the pancreas.