Med. praxi. 2011;8(11):455-458

Chronic pancreatitis

prof.MUDr.Petr Dítě, DrSc., MUDr.Jan Trna, MUDr.Katarina Floreanová, MUDr.Edvard Geryk

Lékařská fakulta Ostrava, Fakultní nemocnice Brno

Chronic pancreatitis is among the diseases whose incidence is rising very slightly, but distinctly. The disease is initiated by a number of

aetiological risk factors, such as alcohol, smoking, genetic or autoimmune factors. In principle, our knowledge on the aetiological factors

of the disease is summarized in the TIGAR-O classification of chronic pancreatitis. Except hereditary, autoimmune and, to a certain degree,

obstructive forms, however, the present risk factor must be accompanied by the presence of another of the factors for the disease to really

develop. The diagnosis of chronic pancreatitis is currently based on the use of imaging techniques and/or histomorphological criteria.

Particularly, nuclear magnetic resonance imaging and computed tomography as noninvasive methods are the methods of first choice;

endosonography which enables to perform safe targeted biopsy is a method used, in addition to evaluating changes in the parenchyma and

pancreatic duct system, to obtain material for cytological and/or histological assessment. Endoscopic retrograde cholangiopancreatography

is not used as a diagnostic tool in most indications; however, it is an irreplaceable therapeutic method. The treatment of chronic pancreatitis

consists in dietary measures, particularly in absolute cessation of alcohol consumption, followed by the management of pancreatic pain with

paracetamol or tramadol being recommended as the drug of first choice; pancreatic enzymes are currently indicated not only in persons

with exocrine pancreatic insufficiency. When conservative therapy fails, endoscopic treatment is indicated allowing drainage procedures

and/or surgical drainage and resection. Chronic pancreatitis is a condition that significantly reduces the quality of life of patients but, primarily,

is a risk factor for developing pancreatic cancer, which is particularly true for hereditary pancreatitis.

Keywords: chronic pancreatitis, alcohol, genetics, autoimmunity, imaging techniques, pancreatic substitution, endoscopy, surgery

Published: January 1, 2011  Show citation