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World J Gastrointest Endosc. Jan 16, 2013; 5(1): 19-28
Published online Jan 16, 2013. doi: 10.4253/wjge.v5.i1.19
Endoscopic management of chronic pancreatitis
Veeral M Oza, Michel Kahaleh
Veeral M Oza, Michel Kahaleh, Division of Gastroenterology and Hepatology, Weill Cornell Medical Center, New York Presbyterian Hospital, New York, NY 10021, United States
Author contributions: Oza VM contributed to write as well as literature review, develope the tables presented in this article, perform the literature search and in creation of the data tables that would help the reader interpret the number of different studies published over the years, scriptiand edit of this article; Kahaleh M contributed to write the article, conceptualize the topic, and was involved with literature search as well as with drafting and editing this paper.
Correspondence to: Michel Kahaleh, MD, AGAF, FACG, FASGE, Chief of Endoscopy, Professor of Clinical Medicine, Division of Gastroenterology and Hepatology, Weill Cornell Medical Center, New York Presbyterian Hospital, 1305 York Avenue, 4th Floor, New York, NY 10021, United States.
Telephone: +1-646-9624000 Fax: +1-646-9620110
Received: January 8, 2012
Revised: September 23, 2012
Accepted: December 1, 2012
Published online: January 16, 2013

Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

Keywords: Chronic Pancreatitis, Biliary strictures, Pseudocysts, Endoscopic management, Pain, Pancreatic stones