Avtor/Urednik		Mlinarič, Vladimir
Naslov		Endoscopic therapy of chronic pancreatitis
Tip		članek
Vir		Gastroenterolog
Vol. in št.		Letnik 7, št. 1
Leto izdaje		2003
Obseg		str. 41-5
Jezik		eng
Abstrakt		The incidence of chronic pancreatitis (CP) in Western civilization ranges between 5 and 10 per 100,000 inhabitants. The most common cause is chronic alcohol abuse. The diagnosis of CP is confirmed by ultrasonography (US) or computer tomography (CT) and/or magnetic resonance cholangiopancreatography (MRCP). To date, endoscopic retrograde cholangiopancreatography (ERCP) has been the gold standard in diagnosing ductal irregularities in moderate and severe CP. Endoscopic ultrasonography (EUS) might be a more sensitive imaging method in detecting early lesions of CP. Enodscopic pancreatic sphincterotomy (EPS) can be the definite treatment in some patients (e.g. sphincter of Oddi dysfunction, papillary stenosis, pancreas divisum). In most patients, it represents the initial procedure followed by other techniques. Pancreatic duct stones can be removed by a special Dormia basket in combination with mechanical lithotripsy, by balloon catheter, extracorporeal shock wave lithotripsy (ESWL) or intracorporeal shock wave lithotripsy ISWL (electrohydraulic or laser-induced). Over the past 10 years, many endoscopic drainage procedures were established. In case of single stricture, endoscopic balloon dilation or bougienage might be helpful. In most of the patients selected for endoscopic drainage, the insertion of a pancreatic plastic stent is mandatory. Indications for endoscopic therapy of stenosed common bile duct due to CP are obstructive jaundice and cholangitis. Plastic stent is a temporary solution before surgical therapy. Self-expandable metal mesh stents can be an alternative to surgical treatment in the selected group of patients with CP and biliary stenosis. Treatment of pancreatic pseudocysts is recommended if they are larger than 5 - 6 cm in diameter (increasing risk of cyst rupture or infection), or if they are suspected to cause local complications. (Abstract truncated at 2000 characters).
Deskriptorji		PANCREATITIS SPHINCTEROTOMY, ENDOSCOPIC CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE CHRONIC DISEASE PANCREATIC PSEUDOCYST PANCREATIC DUCTS STENTS BILE DUCT OBSTRUCTION, EXTRAHEPATIC