Chronic pancreatitis |
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| Affiliation: | 1. Department of Anesthesiology, Perioperative and General Critical Care Medicine, Salzburg General Hospital, Paracelsus Medical University, Salzburg, Austria;2. Department of Anesthesiology, University Hospital Heidelberg, Germany;3. Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;4. Critical Care Research Area, NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;5. Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK;6. UCL Centre for Altitude, Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, First Floor, 170 Tottenham Court Road, London W1T 7HA, UK |
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| Abstract: | Chronic pancreatitis is distinguished by structural and functional criteria. Alcohol is the major aetiological factor, but about 20% of patients have another cause such as hereditary pancreatitis. Abdominal pain is the usual presenting feature, often as recurrent attacks of acute pancreatitis but chronic pancreatitis may be clinically silent. The pathogenesis of chronic pancreatitis is incompletely understood. Diagnosis is usually made on imaging (CT, magnetic resonance cholangiopancreatography, endoscopic ultrasound). Complications include exocrine and endocrine insufficiency, obstructive jaundice, duodenal obstruction, left-sided portal hypertension, and the development of pancreatic cancer. Overall management is difficult and depends upon symptoms, morphological characteristics and complications. Treatment options include medical, endoscopic, and surgical strategies; the latter is reserved for patients with complications. Early involvement of a specialist centre in the care of patients with complicated chronic pancreatitis is important and should be encouraged. |
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| Keywords: | Chronic pain chronic pancreatitis exocrine insufficiency Frey procedure pancreas |
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