Endoscopic treatment of chronic pancreatitis

Treatment of chronicpancreatitis has been exclusively surgical for a long time. Recently, endoscopic therapyhas become widely used as a primary therapeutic option.Initially performed for drainage ofpancreatic cysts and pseudocysts, endoscopic treatments were adapted to biliary andpancreatic ducts stenosis. Pancreatic sphincterotomy which allows access to pancreaticducts was firstly reported. Secondly, endoscopic methods of stenting, dilatation, andstones extraction of the bile ducts were applied to pancreatic ducts. Nevertheless,newimprovements were necessary failures of pancreatic stone extraction justified thedevelopment of extra-corporeal shock wave lithotripsy; dilatation of pancreatic stenosiswas improved by forage with a new device; moreover endosonography allowed guidance forceliac block, gastro-cystostomy, duodeno-cystostomy and pancreatico-gastrostomy. Althoughendoscopic treatments are more and more frequently accepted,indications are still debated.