Department of Internal Medicine, Saint Agnes Medical Center, 1303 E Herndon Ave, Fresno, CA 93720, USA.
Department of Internal Medicine, Bassett Healthcare Network, Columbia Bassett Medical School, 1 Atwell Road, Cooperstown, NY 13326, USA.
Dis Mon. 2021 Dec;67(12):101225. doi: 10.1016/j.disamonth.2021.101225. Epub 2021 Jun 24.
Chronic pancreatitis is characterized by irreversible destruction of pancreatic parenchyma and its ductal system resulting from longstanding inflammation, leading to fibrosis and scarring due to genetic, environmental, and other risk factors. The diagnosis of chronic pancreatitis is made based on a combination of clinical features and characteristic findings on computed tomography or magnetic resonance imaging. Abdominal pain is the most common symptom of chronic pancreatitis. The main aim of treatment is to relieve symptoms, prevent disease progression, and manage complications related to chronic pancreatitis. Patients who do not respond to medical treatment or not a candidate for surgical treatment are usually managed with endoscopic therapies. Endoscopic therapies help with symptoms such as abdominal pain and jaundice by decompression of pancreatic and biliary ducts. This review summarizes the risk factors, pathophysiology, diagnostic evaluation, endoscopic treatment of chronic pancreatitis, and complications. We have also reviewed recent advances in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided therapies for pancreatic duct obstruction due to stones, strictures, pancreatic divisum, and biliary strictures.
慢性胰腺炎的特征是由于长期炎症导致胰腺实质及其导管系统的不可逆转破坏,导致纤维化和瘢痕形成,其病因包括遗传、环境和其他危险因素。慢性胰腺炎的诊断基于临床特征和计算机断层扫描或磁共振成像的特征性发现。腹痛是慢性胰腺炎最常见的症状。治疗的主要目的是缓解症状、防止疾病进展和治疗与慢性胰腺炎相关的并发症。对于药物治疗无效或不适合手术治疗的患者,通常采用内镜治疗。内镜治疗通过胰腺和胆管的减压来缓解腹痛和黄疸等症状。本文综述了慢性胰腺炎的危险因素、病理生理学、诊断评估、内镜治疗以及并发症。我们还回顾了近年来在胆胰管结石、狭窄、胰腺分裂和胆管狭窄所致胰管梗阻的内镜逆行胰胆管造影和内镜超声引导治疗方面的进展。
Dis Mon. 2021-12
Orv Hetil. 2011-10-30
Best Pract Res Clin Gastroenterol. 2008
Am Fam Physician. 2007-12-1
Korean J Intern Med. 2012-2-28
J Gastroenterol Hepatol. 2013-12
J Pediatr Gastroenterol Nutr. 2003-2
Dig Dis Sci. 2022-5
JAMA. 2019-12-24
Front Physiol. 2025-7-10
World J Radiol. 2024-3-28
Cureus. 2023-4-14