Treatment options in painful chronic pancreatitis: a systematic review

D’Haese, Jan G.; Ceyhan, Güralp O.; Demir, Ihsan Ekin; Tieftrunk, Elke; Friess, Helmut

doi:10.1111/hpb.12173

Cited by 53 publications

(33 citation statements)

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“…In the past decade and a half, there has been intense investigation towards a neurobiological understanding of pain in chronic pancreatitis [33,34] (Fig. 1).…”

Section: Pain In Chronic Pancreatitismentioning

confidence: 99%

Surgical Management of Chronic Pancreatitis

Parekh

Natarajan

2015

Indian J Surg

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Advances over the past decade have indicated that a complex interplay between environmental factors, genetic predisposition, alcohol abuse, and smoking lead towards the development of chronic pancreatitis. Chronic pancreatitis is a complex disorder that causes significant and chronic incapacity in patients and a substantial burden on the society. Major advances have been made in the etiology and pathogenesis of this disease and the role of genetic predisposition is increasingly coming to the fore. Advances in noninvasive diagnostic modalities now allow for better diagnosis of chronic pancreatitis at an early stage of the disease. The impact of these advances on surgical treatment is beginning to emerge, for example, patients with certain genetic predispositions may be better treated with total pancreatectomy versus lesser procedures. Considerable controversy remains with respect to the surgical management of chronic pancreatitis. Modern understanding of the neurobiology of pain in chronic pancreatitis suggests that a window of opportunity exists for effective treatment of the intractable pain after which central sensitization can lead to an irreversible pain syndrome in patients with chronic pancreatitis. Effective surgical procedures exist for chronic pancreatitis; however, the timing of surgery is unclear. For optimal treatment of patients with chronic pancreatitis, close collaboration between a multidisciplinary team including gastroenterologists, surgeons, and pain management physicians is needed.

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“…In the past decade and a half, there has been intense investigation towards a neurobiological understanding of pain in chronic pancreatitis [33,34] (Fig. 1).…”

Section: Pain In Chronic Pancreatitismentioning

confidence: 99%

Surgical Management of Chronic Pancreatitis

Parekh

Natarajan

2015

Indian J Surg

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“…It is not uncommon for patients with CP to require rapidly increasing doses of strong opioids risking tolerance and hyperalgesic side effects. Adjuncts such as gabapentin tricyclic antidepressants have been shown to be beneficial 56. Care should be taken when prescribing to avoid polypharmacy and opioid dependence.…”

Section: Management Of Cpmentioning

confidence: 99%

Practical guide to the management of chronic pancreatitis

Jalal

Campbell

Hopper

2018

Frontline Gastroenterol

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Chronic pancreatitis (CP) is an irreversible fibroinflammatory disorder of the pancreas. It presents with relapsing, remitting upper abdominal pain accompanied by features of malabsorption due to pancreatic exocrine insufficiency and endocrine deficiency with the development of diabetes mellitus. The associated increased hospitalisation and high economic burden are related to CP often presenting at advanced stage with irreversible consequences. Diagnosing CP at an early stage is still challenging and therefore CP is believed to be under-reported. Our understanding of this disease has evolved over the last few years with attempts to redesign the definition of CP. Better recognition of the risk factors and conditions associated with CP can lead to an earlier diagnosis and coupled with a multidisciplinary approach to treatment, ultimately reduce complications. This article reviews the epidemiology, risk factors, diagnosis and management of CP.

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“…The best treatment option depends on the etiology of the pancreatitis and on individual anatomical considerations (D'Haese et al 2014 ). Proximal duct obstruction can be treated with an endoscopically placed stent, which may alleviate symptoms.…”

Section: Treatment Optionsmentioning

confidence: 99%