Endoscopic Therapy for Chronic Recurrent Pancreatitis

Yoshiaki Kawaguchi, Tetsuya Mine


Chronic recurrent pancreatitis develops as a result of pancreatic outflow disturbance associated with pancreatic duct stenosis or pancreatic stones in most cases. Therefore it is rational to reduce intrapancreatic ductal pressure by removing pancreatic outflow disturbance for treatment of chronic recurrent pancreatitis. Surgical procedures and endoscopic pancreatic stenting are available for decompression of the pancreatic duct. As endoscopic pancreatic stenting is less invasive, safe and effective method, this approach has spread rapidly. Comorbid pancreatic cancer should never be overlooked before stenting for chronic recurrent pancreatitis, because chronic recurrent pancreatitis carries a high risk of progressing to pancreatic cancer. In cases with a stone in the pancreatic duct, extracorporeal shock wave lithotripsy (ESWL) should be performed in combination with endoscopic pancreatic stenting. In this review we discuss the current status of endoscopic pancreatic stenting in the treatment of chronic recurrent pancreatitis.

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