The treatment strategies for chronic pancreatitis: endoscopic treatment or surgical intervention
10.3760/cma.j.cn115610-20210317-00129
- VernacularTitle:慢性胰腺炎的治疗策略：内镜治疗与外科干预
- Author:
Bei SUN
;
Guanqun LI
- From:
Chinese Journal of Digestive Surgery
2021;20(4):395-400
- CountryChina
- Language:Chinese
-
Abstract:
Chronic pancreatitis (CP) is a chronic inflammatory and fibrotic disease of the pancreas caused by a variety of causes. The basic treatment principle of CP is to remove the etiology, control the symptoms, improve the pancreatic secretory function and prevent the complications. At present, more and more studies have been conducted on CP treatment strategies. The step-up approach and the surgery first approach are both effective strategies for CP treatment. In clinical practice, endoscopic intervention can be the preferred treatment for pancreatic pseudocyst, pancreatic duct stone, and biliary stenosis. Partington operation is the first choice for dilated main pancreatic duct patients without pancreatic head lesion. Patients with pancreatic head lesions should be intervened with the Beger or Frey operation. For patients without main pancreatic duct dilatation, pancreatectomy should be performed according to the specific lesion location. The total pancreatectomy is advisable for patients with total pancreatic inflammatory disease or multiple lesions of pancreas. Surgeons should follow the individualized and multidisciplinary treatment concepts and strategies in choosing surgical procedures, especially for the control of surgical indications, timing and methods. The authors comprehensively analyze the research progress at home and abroad, elaborate the endoscopic treatment and surgical intervention strategies of CP in order to further optimize the overall efficacy of CP.
