[Value of endoscopy in the treatment of chronic pancreatitis]

Endoscopic treatment in patients with chronic pancreatitis involves several features: sphincterotomy of the wirsung, dilatation, insertion of a prosthesis, cystoenterostomy, cystowirsungostomy. Extracorporal lithotrity is often associated. Endoscopic treatment appears to give satisfactory short-term results in cases with pain, pseudocyst or pancreatic fistula. Morbidity is low. The optimum duration of endoscopic drainage via the prosthesis is still a question of debate and the long-term efficacy remains to be demonstrated. Endoscopic treatment is indicated in patients with a definitive or temporary surgical risk or may be indicated for all symptomatic patients. In this case, endoscopic treatment would be used as a therapeutic test. Stenosis of the main bile duct is not at present a good indication for endoscopic treatment as this stenosis is resistant to balloon dilatation and prosthesis calibration.