Domínguez-Muñoz J Enrique, Iglesias-García Julio
Servicio de Aparato Digestivo, Fundación para la Investigación en Enfermedades del Aparato Digestivo (FIENAD), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Gastroenterol Hepatol. 2012 Sep;35 Suppl 1:86-90. doi: 10.1016/S0210-5705(12)70039-0.
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.
慢性胰腺炎最重要的进展涉及到其病因发病机制、营养方面以及诊断技术和一些治疗选择的改进。在这种疾病的病因发病机制方面，吸烟的重要性及其与酒精的关联已得到证实。慢性胰腺炎继发的外分泌性胰腺功能不全（EPI）与骨代谢改变（骨质减少和骨质疏松）、脂溶性维生素减少以及必需氨基酸水平改变有关。内镜超声已被确认为诊断慢性胰腺炎最先进的技术，特别是由于新的图像优化技术。用于诊断EPI的呼气试验仍在不断发展（C-13混合甘油三酯试验的优化以及基于C-13标记碳酸氢盐测定的新试验的开发）。使用抗氧化剂、胰酶和/或静脉注射促胰液素在疼痛治疗方面取得了一定成果。慢性胰腺炎与胰腺癌的关联需要严格随访，尤其是在慢性胰腺炎背景下有炎性肿块的患者中。
