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2014 ; 55
(12
): 613-20
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Current status of endotherapy for chronic pancreatitis
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Kwek AB
; Ang TL
; Maydeo A
Singapore Med J
2014[Dec]; 55
(12
): 613-20
PMID25630314
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Chronic pancreatitis is associated with varied morphological complications,
including intraductal stones, main pancreatic ductal strictures, distal biliary
strictures and pseudocysts. Endoscopic therapy provides a less invasive
alternative to surgery. In addition, extracorporeal shockwave lithotripsy
improves the success rate of endoscopic clearance of intraductal stones. However,
recent data from randomised trials have shown better long-term outcomes with
surgical drainage for obstructive pancreatic ductal disease. In patients with
distal biliary strictures, stent insertion leads to good immediate drainage, but
after stent removal, recurrent narrowing is common. Endoscopic drainage of
pancreatic pseudocysts has excellent outcome and should be accompanied by
pancreatic ductal stenting when a ductal communication is evident. In those who
remain symptomatic, endoscopic ultrasonography-guided coeliac plexus block may
provide effective but short-term pain relief. In this review, we present the
current evidence for the role of endotherapy in the management of patients with
chronic pancreatitis.
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