Issa Y, van Santvoort H C, van Goor H, Cahen D L, Bruno M J, Boermeester M A
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Dig Surg. 2013;30(1):35-50. doi: 10.1159/000350153. Epub 2013 Apr 26.
Chronic pancreatitis is an inflammatory disease of the pancreas with abdominal pain as the most prominent symptom. Adequate treatment of patients with chronic pancreatitis remains a major challenge, mainly because of the lack of evidence-based treatment protocols. The primary goal of treatment is to achieve long-term pain relief, control of the complications associated with the disease, and to restore the quality of life. Currently, a conservative step-up approach is often used for the treatment of pain; progression to severe and intractable pain is considered necessary before invasive treatment is considered. Recent studies, however, suggest that surgical intervention should not be considered only as last-resort treatment, since it can mitigate disease progression, achieve excellent pain control, and preserve pancreatic function. In this review, we present a state-of-the art overview of endoscopic and surgical treatment options for patients with painful chronic pancreatitis, and elaborate on the timing of surgery.
慢性胰腺炎是一种胰腺炎症性疾病，腹痛是最突出的症状。对慢性胰腺炎患者进行充分治疗仍然是一项重大挑战，主要原因是缺乏循证治疗方案。治疗的主要目标是实现长期疼痛缓解、控制与该疾病相关的并发症并恢复生活质量。目前，对于疼痛的治疗通常采用保守的逐步升级方法；在考虑进行侵入性治疗之前，认为有必要发展到严重且难以治疗的疼痛阶段。然而，最近的研究表明，手术干预不应仅被视为最后的治疗手段，因为它可以减轻疾病进展、实现出色的疼痛控制并保留胰腺功能。在本综述中，我们对疼痛性慢性胰腺炎患者的内镜和手术治疗选择进行了最新概述，并阐述了手术时机。
