The aim of endoscopic therapy of chronic-pancreatitis (CP) is to treat pain by draining the pancreatic duct or managing locoregional complications. Recent decennia were characterized by continuous improvement of endoscopic techniques and devices, resulting in a better clinical outcome. Novel developments now also provide the opportunity to endoscopically treat refractory CP-related complications. Especially suboptimal surgical candidates could potentially benefit from these new developments, consequently avoiding invasive surgery. The use of fully covered self-expandable metal stents (SEMS) has been explored in pancreatic and CP-related biliary duct strictures, resistant to conventional treatment with plastic endoprotheses. Furthermore, endosonography-guided transmural drainage of the main pancreatic duct via duct-gastrostomy is an alternative treatment option in selected cases. Pancreatic pseudocysts represent an excellent indication for endoscopic therapy with some recent case series demonstrating effective drainage with the use of a fully covered SEMS. Although results of these new endoscopic developments are promising, high quality randomized trials are required to determine their definite role in the management of chronic pancreatitis.

Celiac plexus, Cholestasis, extrahepatic, Duodenal obstruction, Endoscopy, Pancreatic pseudocyst, Pancreatitis, chronic, Stents
hdl.handle.net/1765/90576
Minerva gastroenterologica e dietologica
Department of Gastroenterology & Hepatology

Didden, P, Bruno, M.J, & Poley, J.-W. (2012). New developments in endoscopic treatment of chronic pancreatitis. Minerva gastroenterologica e dietologica (Vol. 58, pp. 309–319). Retrieved from http://hdl.handle.net/1765/90576