New developments in endoscopic treatment of chronic pancreatitis
Minerva gastroenterologica e dietologica , Volume 58 - Issue 4 p. 309- 319
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|
|Minerva gastroenterologica e dietologica|
|Organisation||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