New Modalities for Treating Chronic Pancreatitis

Grimm, H; Wh, Meyer; Vc, Nam; Soehendra, Nib

doi:10.1055/s-2007-1012903

Cited by 123 publications

(42 citation statements)

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“…In that group of patients, 53% remained free of symptoms over a mean follow-up period of 36 mo. Similarly, Grimm et al [43] showed that 57% of their patients were symptomatically improved by this treatment over a mean follow-up period of 19 mo. Although these results seem encouraging, a criticism is that most of the data reported to date were from relatively short term, nonrandomized studies.…”

Section: Endoscopic Therapymentioning

confidence: 82%

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Pain management in chronic pancreatitis

Gachago¹,

Draganov²

2008

WJG

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Section: Endoscopic Therapymentioning

confidence: 82%

“…Reports indicate that 30%-76% of patients receiving such stents had symptomatic improvement over a period of 14 to 36 mo of observation [42][43][44][45][46] . Cremer et al [42] , for example, noted initial improvement of symptoms in 94% of patients who were so treated for pancreaticduct strictures and upstream ductal dilatation.…”

Section: Endoscopic Therapymentioning

confidence: 99%

Pain management in chronic pancreatitis

Gachago¹,

Draganov²

2008

WJG

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“…Several studies place the technical success of transmural drainage of pseudocyst at 85%-100%. The recurrence rate range from 10%-15% with complications between 10%-34% [63,[66][67][68] . In recent years, EUS-guided pseudocyst (EGPD) drainage has gained in popularity since it allow to avoid intervening vessels and target more challenging collections safely when compared to conventional transmural drainage Sauerbruch et al [107] 8 8 8 11 Den Toom et al [108] 8 8 (7 pain relief) 8 17 Sauerbruch et al [109] 24 24 24 24 Delhaye et al [60] 123 88 123 Schneider et al [110] 50 39 48 20 Van der Hul et al [111] 17 17 17 30 Wolf et al [112] 12 9 12 19-22 Schreiber et al [113] 10 7 10 12 Johanns et al [114] 35 23 16 NA Ohara et al [115] Uncovered metal stents have also been evaluated.…”

Section: Pancreatic Pseudocystsmentioning

confidence: 99%

Endoscopic management of chronic pancreatitis

Oza

Kahaleh²

2013

WJGE

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Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

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“…Drainage of pancreatic duct is reported in numerous articles [11,13,14,23,[38][39][40][41][42][43][44][45] . Technical success was obtained in 85% of cases (58%-96%).…”

Section: Treatment Of Pancreatic Painmentioning

confidence: 99%

Endoscopic treatment of chronic pancreatitis

Heyries¹,

Sahel²

2007

WJG

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Treatment of chronic pancreatitis has been exclusively surgical for a long time. Recently, endoscopic therapy has become widely used as a primary therapeutic option. Initially performed for drainage of pancreatic cysts and pseudocysts, endoscopic treatments were adapted to biliary and pancreatic ducts stenosis. Pancreatic sphincterotomy which allows access to pancreatic ducts was firstly reported. Secondly, endoscopic methods of stenting, dilatation, and stones extraction of the bile ducts were applied to pancreatic ducts. Nevertheless, n e w i m p r o v e m e n t s w e r e n e c e s s a r y : f a i l u r e s o f pancreatic stone extraction justified the development of extra-corporeal shock wave lithotripsy; dilatation of pancreatic stenosis was improved by forage with a new device; moreover endosonography allowed guidance for celiac block, gastro-cystostomy, duodeno-cystostomy and pancreatico-gastrostomy. Although endoscopic treatments are more and more frequently accepted, indications are still debated. METHODSEndoscopic treatment needs a team (operator, anaesthesiologist) aware with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Specific material is necessary: good fluoroscopy with the possibility to magnify pictures, and a duodenoscope with a 4.2 channel allowing insertion of high calibre stent (10 Fr). Moreover, a wide variety of endoscopic ancillar y instruments is essential: metallic and hydrophilic guidewire, sphincterotomes, Dormia basket, balloon dilatators and bougie dilatators (5-11.5 Fr), but also very thin guide wire (0.025 inches), fine-tipped sphincterotomes, Soehendra extractors (cf infra) [1] . Impaction of stones in pancreatic ducts needs the use of extracorporeal shock wave lithotripsy before endoscopic stone extraction [2]

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New Modalities for Treating Chronic Pancreatitis

Cited by 123 publications

References 0 publications

Pain management in chronic pancreatitis

Pain management in chronic pancreatitis

Endoscopic management of chronic pancreatitis

Endoscopic treatment of chronic pancreatitis

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