S3-Leitlinie Chronische Pankreatitis: Definition, Ätiologie, Diagnostik, konservative, interventionell endoskopische und operative Therapie der chronischen Pankreatitis. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)

Hoffmeister, Albrecht; Mayerle, Julia; Beglinger, Christoph; Büchler, Markus W.; Bufler, Philip; Dathe, Katarina; Fölsch, Ulrich R.; Frieß, Helmut; Izbicki, Jakob R.; Kahl, Stefan; Klar, E.; Keller, Jutta; Knoefel, W. T.; Layer, Peter; Loehr, Matthias; Meier, Rémy; Riemann, Jürgen F.; Rünzi, Michael; Schmid, RM; Schreyer, A. G.; Tribl, Barbara; Werner, Jens; Witt, Heiko; Mössner, Joachim; Lerch, Markus M.

doi:10.1055/s-0032-1325479

Cited by 141 publications

(45 citation statements)

References 88 publications

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“…Chronic pancreatitis has an incidence of 4–14/100,000 per year and a prevalence of 13–52/100,000 [2, 35]. Chronic pancreatitis is defined as a continuous inflammatory degeneration of the exocrine and endocrine pancreatic tissue with irreversible morphological changes [36].…”

Section: Recurrent Acute and Chronic Pancreatitis: Distinction And Etmentioning

confidence: 99%

Etiology and Risk Factors of Acute and Chronic Pancreatitis

Weiss

Laemmerhirt

Lerch³

2019

Visc Med

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Based on the recognition of common etiological and genetic risk factors, acute and chronic pancreatitis are increasingly regarded as a continuum of the same disease, with a significant overlap of clinical manifestations and phenotypes but distinct morphological and imaging appearances. Recent population-based and cohort studies have found that tobacco smoke conveys a greater risk than immoderate alcohol consumption for the development of chronic pancreatitis, and hypertriglyceridemia has been identified as a risk factor for acute pancreatitis – even when plasma levels are only mildly elevated. Hereditary pancreatitis, in its autosomal dominant form, is associated with mutations in the cationic trypsinogen gene (PRSS1), whereas a number of germline variations in other genes have been found to represent risk factors for chronic as well as acute pancreatitis. For now, most of these involve the pancreatic digestive protease/antiprotease system. Oftentimes, affected patients are burdened with multiple or accumulating risk factors, and genetic traits when combined with environmental toxins compound the chance of developing the disease. Determining the underlying etiology of pancreatitis is worth the effort since formerly intractable varieties such as autoimmune pancreatitis are now becoming increasingly treatable, and subtype-specific therapeutic modalities may become available.

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Section: Recurrent Acute and Chronic Pancreatitis: Distinction And Etmentioning

confidence: 99%

Etiology and Risk Factors of Acute and Chronic Pancreatitis

Weiss

Laemmerhirt

Lerch³

2019

Visc Med

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“…There is no evidence and hence no recommendation for smoking cessation in chronic pancreatitis and pancreatic exocrine insufficiency (PEI) despite some reports [8,19], even in acute pancreatitis [5,6,7,8,20]. Smoking cessation is recommended (evidence 3b, recommendation A).…”

Section: Medical Therapy Of Chronic Pancreatitismentioning

confidence: 99%

“…with fasting blood glucose (evidence 4, recommendation C), as many patients with chronic pancreatitis may already have impaired glucose tolerance but no overt diabetes mellitus. This is called type 3c diabetes mellitus [7,24]. A patient's compliance regarding diet and intake of medication should be assumed (recommendation A).…”

Section: Medical Therapy Of Chronic Pancreatitismentioning

confidence: 99%

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Conservative Treatment of Chronic Pancreatitis

Löhr

Haas²,

Lindgren³

et al. 2013

Dig Dis

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Background: Chronic pancreatitis is a progressive inflammatory disease giving rise to several complications that need to be treated accordingly. Because pancreatic surgery has significant morbidity and mortality, less invasive therapy seems to be an attractive option. Aim: This paper reviews current state-of-the-art strategies to treat chronic pancreatitis without surgery and the current guidelines for the medical therapy of chronic pancreatitis. Results: Endoscopic therapy of complications of chronic pancreatitis such as pain, main pancreatic duct strictures and stones as well as pseudocysts is technically feasible and safe. The long-term outcome, however, is inferior to definitive surgical procedures such as resection or drainage. On the other hand, the medical therapy of pancreatic endocrine and exocrine insufficiency is well established and evidence based. Conclusions: Endoscopic therapy may be an option to bridge for surgery and in children/young adolescents and those unfit for surgery. Pain in chronic pancreatitis as well as treatment of pancreatic exocrine insufficiency follows established guidelines.

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“…Seit einigen Jahren wird zur Diagnostik der postoperativen Pankreasfistel eine internationale Konsensdefinition verwendet, die sich vor allem auf den Nachweis von Amylase (und/oder Lipase) aus den abdominellen Drainagen stützt [14]. Ferner kann die Aktivität von Pankreasenzymen zur Diagnose von pankreatogenem Aszites herangezogen werden [15,16]. Der zweite Aspekt ist der klinische Erfolg.…”

Section: Hartlunclassified

Sepsisquelle Abdomen - zwischen interventioneller, chirurgischer und intensivmedizinischer Therapie

Muhl¹

2013

Viszeralmedizin

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S3-Leitlinie Chronische Pankreatitis: Definition, Ätiologie, Diagnostik, konservative, interventionell endoskopische und operative Therapie der chronischen Pankreatitis. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS)

Cited by 141 publications

References 88 publications

Etiology and Risk Factors of Acute and Chronic Pancreatitis

Etiology and Risk Factors of Acute and Chronic Pancreatitis

Conservative Treatment of Chronic Pancreatitis

Sepsisquelle Abdomen - zwischen interventioneller, chirurgischer und intensivmedizinischer Therapie

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