Progress in mechanism and endoscopic therapy on pain in chronic pancreatitis

VernacularTitle:慢性胰腺炎疼痛的机制及内镜治疗进展
Author: Siyan YU ; Hongjun XIE ; Gaojue WU
Publication Type:Journal Article
From: Journal of Surgery Concepts & Practice 2025;30(5):444-449
CountryChina
Language:Chinese
Abstract: Epigastric pain, the most common symptom of chronic pancreatitis (CP), seriously affects the quality of life and causes huge social and economic burden. The pathogenesis of pain involves pancreatic duct hypertension, neurogenic mechanisms, and the effects of inflammatory mediators. As a minimally invasive treatment, endoscopic therapy has emerged as a pivotal option for pain treatment in CP, primarily encompassing pancreatic duct decompression techniques and nerve interventions under endoscopy. Endoscopic pancreatic duct decompression, based on endoscopic retrograde cholangiopancreatography (ERCP) and combined with extracorporeal shock wave lithotripsy (ESWL), can effectively reduce pancreatic duct pressure and relieve pain through pancreatic duct stone removal and main pancreatic duct stent implantation. Endoscopic nerve intervention techniques mainly include celiac plexus block/neurolysis and radiofrequency ablation under the guidance of endoscopic ultrasonography (EUS), which can relieve pain by inhibiting nociceptive transmission or destroying nerve fibers. This article reviewed the mechanism of CP abdominal pain and the progress of endoscopic treatment.