[Latest advances in chronic pancreatitis]

The most important advances in chronic pancreatitis concern its etiopathogenesis, nutritional aspects, and improvements in diagnostic techniques and some treatment options. In the etiopathogenesis of this disease, the importance of smoking and its association with alcohol have been confirmed. Exocrine pancreatic insufficiency (EPI) secondary to chronic pancreatitis is associated with bone metabolism alterations (osteopenia and osteoporosis), a reduction in liposoluble vitamins and alterations in essential amino acid levels. Endoscopic ultrasound has been confirmed as the most highly developed technique for the diagnosis of chronic pancreatitis, especially due to new image optimization technologies. Breath tests for the diagnosis of EPI continue to be developed (optimization of the C-13 mixed triglyceride test and the development of a new test based on C-13-labelled bicarbonate determination). Modest results in pain treatment have been achieved with the use of antioxidants, pancreatic enzymes and/or intravenous secretin. The association of chronic pancreatitis with pancreatic cancer requires strict follow-up, especially in patients with inflammatory masses in the context of chronic pancreatitis.