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Related Concept Videos

Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
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Chronic Pancreatitis I: Introduction01:24

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
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Chronic Pancreatitis I: Introduction01:25

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Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80%...
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Endoscopic Procedures V: ERCP01:26

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Chronic Pancreatitis II: Pathophysiology01:21

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Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...
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Acute Pancreatitis I: Introduction01:25

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Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
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Endoscopic therapy in chronic pancreatitis: current perspectives.

Andrada Seicean1, Simona Vultur1

  • 1Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.

Clinical and Experimental Gastroenterology
|January 8, 2015
PubMed
Summary

Endoscopic therapy, including ERCP and EUS, is a first-line treatment for painful chronic pancreatitis (CP) and its complications. This approach offers pain relief and treats issues like stones, strictures, and pseudocysts.

Keywords:
ERCPchronic pancreatitisendoscopic ultrasoundendoscopytreatment

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy

Background:

  • Chronic pancreatitis (CP) management focuses on pain relief and treating complications.
  • Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are key therapeutic modalities.

Purpose of the Study:

  • To review endoscopic therapies for chronic pancreatitis (CP).
  • To highlight the role of ERCP and EUS in managing CP complications.

Main Methods:

  • Review of ERCP-based therapies including lithotripsy for stones and stenting for strictures.
  • Discussion of EUS-guided interventions such as main pancreatic duct drainage and pseudocyst management.
  • Evaluation of EUS-guided celiac plexus block and transpapillary/transgastric pseudocyst drainage.

Main Results:

  • Endoscopic therapy is effective for pancreatic duct stones, strictures, and pseudocysts.
  • Stenting is a primary treatment for pancreatic duct strictures, with multiple stents used if necessary.
  • EUS-guided techniques offer solutions for ductal strictures and pseudocysts, especially when ERCP is unsuccessful.

Conclusions:

  • Endoscopic procedures (ERCP and EUS) are the preferred first-line treatment for symptomatic chronic pancreatitis.
  • A multidisciplinary team approach is crucial for optimal patient management.
  • Careful consideration of surgical timing remains essential alongside endoscopic interventions.