Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Lancet. 2016 May 7;387(10031):1957-66. doi: 10.1016/S0140-6736(16)00097-0. Epub 2016 Mar 2.
Chronic pancreatitis describes a wide spectrum of fibro-inflammatory disorders of the exocrine pancreas that includes calcifying, obstructive, and steroid-responsive forms. Use of the term chronic pancreatitis without qualification generally refers to calcifying chronic pancreatitis. Epidemiology is poorly defined, but incidence worldwide seems to be on the rise. Smoking, drinking alcohol, and genetic predisposition are the major risk factors for chronic calcifying pancreatitis. In this Seminar, we discuss the clinical features, diagnosis, and management of chronic calcifying pancreatitis, focusing on pain management, the role of endoscopic and surgical intervention, and the use of pancreatic enzyme-replacement therapy. Management of patients is often challenging and necessitates a multidisciplinary approach.
慢性胰腺炎描述了一种广泛的胰腺外分泌腺纤维炎症性疾病谱,包括钙化性、阻塞性和类固醇反应性形式。术语“慢性胰腺炎”的使用没有具体说明,通常是指钙化性慢性胰腺炎。其流行病学定义不明确,但全球发病率似乎呈上升趋势。吸烟、饮酒和遗传易感性是慢性钙化性胰腺炎的主要危险因素。在本次研讨会上,我们讨论了慢性钙化性胰腺炎的临床特征、诊断和治疗,重点是疼痛管理、内镜和手术干预的作用,以及胰腺酶替代治疗的应用。患者的管理通常具有挑战性,需要多学科方法。