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Chronic Pancreatitis: Role of Endoscopic Procedures
Renan Prado1, Arjun Chatterjee2, Leandro Sierra1
1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, 44195, USA.
Digestive Diseases and Sciences
|April 27, 2026
Summary
Endoscopic therapy offers effective management for chronic pancreatitis complications like stones and strictures. However, surgery may provide more durable pain relief for some patients.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Pancreatology
Background:
- Chronic pancreatitis (CP) is a progressive inflammatory condition causing irreversible damage and pain.
- Endoscopic therapy is crucial for managing obstructive CP phenotypes and complications.
Purpose of the Study:
- To review current evidence on endoscopic management of CP complications.
- To assess the role of endoscopy in treating pancreatic duct stones, strictures, leaks, pseudocysts, and pain.
Main Methods:
- Narrative review of ERCP-based therapies, lithotripsy, and endoscopic ultrasound (EUS)-guided interventions.
- Evaluation of pain relief, ductal decompression, quality of life, and adverse events.
Main Results:
- Endoscopy provides symptom relief for painful obstructive CP, but surgery may offer better long-term pain control.
- ERCP is suitable for small stones; larger stones require lithotripsy. Stenting is used for strictures, with caution for metal stents.
- EUS-guided celiac plexus block offers short-term pain relief.
Conclusions:
- Endoscopic therapy is a key component of multidisciplinary CP care.
- Surgery remains the preferred option for durable pain control in select CP patients.
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