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Chronic Pancreatitis
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DOI：10.1056/NEJMcp1809396.png)
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Key Clinical Points Chronic Pancreatitis Chronic pancreatitis, which is commonly associated with alcohol use, smoking, or genetic risk factors, often manifests as recurrent bouts of abdominal pain or pancreatitis. Characteristic imaging findings include pancreatic stones, dilated ducts, and atrophy. Complications of chronic pancreatitis include pseudocysts, biliary strictures, exocrine and endocrine pancreatic insufficiency, bone loss, and pancreatic cancer; there is currently no effective early detection strategy for pancreatic cancer. Exocrine insufficiency causing steatorrhea leads to weight loss, sarcopenia, and deficiencies of fat-soluble vitamins and other micronutrients and is mitigated by treatment with pancreatic-enzyme replacement. Strategies for managing chronic abdominal pain include medical therapies (analgesic agents, limited use of narcotics, antioxidants, and neuromodulators), endoscopic treatment (pancreatic stenting with or without extracorporeal shockwave lithotripsy), and surgical interventions (duct drainage and resection procedures), as well as behavioral interventions for centrally mediated pain. Chronic Pancreatitis Chronic pancreatitis, often associated with alcohol use, smoking, or genetic risk factors, may be complicated by pseudocysts, biliary strictures, pancreatic insufficiency, bone loss, and pancreatic cancer. Aspects of management include structural and nonstructural interventions for pain and treatment with pancreatic-enzyme replacement.
Keyword:
INTERNATIONAL CONSENSUS GUIDELINES
EXOCRINE INSUFFICIENCY
ANTIOXIDANT THERAPY
FECAL ELASTASE-1
PAIN
SURGERY
PERFORMANCE
PREVALENCE
RESILIENCE
MANAGEMENT
期刊
IF:
78.5
论文数:
2.7W
被引数:
39.7W
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