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Review
. 2011 Dec;26(4):384-99.
doi: 10.3904/kjim.2011.26.4.384. Epub 2011 Nov 28.

Endoscopic therapy in chronic pancreatitis

Damien Meng Yew Tan  1 , Stuart Sherman
Affiliations
Review

Endoscopic therapy in chronic pancreatitis

Damien Meng Yew Tan et al. Korean J Intern Med. 2011 Dec.

Abstract

Chronic pancreatitis (CP) is a debilitating disease that can result in chronic abdominal pain, malnutrition, and other related complications. The main aims of treatment are to control symptoms, prevent disease progression, and correct any complications. A multidisciplinary approach involving medical, endoscopic, and surgical therapy is important. Endoscopic therapy plays a specific role in carefully selected patients as primary interventional therapy when medical measures fail or in patients who are not suitable for surgery. Endoscopic therapy is also used as a bridge to surgery or as a means to assess the potential response to pancreatic surgery. This review addresses the role of endoscopic therapy in relief of obstruction of the pancreatic duct (PD) and bile du ct, closure of PD leaks, and drainage of pseudocysts in CP. The role of endoscopic ultrasound-guided celiac plexus block for pain in chronic pancreatitis is also discussed.

Keywords: Cholangiopancreatography, endoscopic retrograde; Endoscopy; Pancreatitis, chronic.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Pancreatic duct stone removal. (A) Pancreatic duct stone at minor papilla. (B) Needle knife sphincterotomy over stone. (C) Passage of stone post-sphincterotomy. (D) Patent dorsal pancreatic duct post-sphincterotomy and stone removal with air bubbles seen in the duct.
Figure 2
Figure 2
Treatment of pancreatic duct leak. (A) Leak seen from ventral duct. (B) Filling of main duct upstream of the leak. (C) Crossing the leak with a wire. (D) Placement of pancreatic stent to bridge the leak.
Figure 3
Figure 3
Pancreatic pseudocyst drainage. (A) Visible bulge in the stomach. (B) Puncture of pseudocyst. (C) Wire in pseudocyst. (D) Dilation of cystogastrostomy tract. (E) Placement of transgastric stents. (F) Fluoroscopic image of transgastric stents.
See this image and copyright information in PMC

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