Chronic pancreatitis: current diagnostic and treatment options

Vaida Vaitiekūnaitė1, Gabija Viederytė1, Giedrius Putriūnas1

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania


Chronic pancreatitis (CP) is a long-term progressive inflammatory disease of the  pancreatic in which the parenchyma progresses to connective tissue due to chronic inflammation. The main etiological factors of the disease are defined in the practical guidelines developed by the American Pancreas Association, the TIGAR-O classification (toxic or alcoholic, idiopathic, genetic, autoimmune, recurrent, and obstructive). Alcohol is the most important risk factor for the disease accounting for as much as 70% of all cases of chronic pancreatitis. The main symptom is abdominal pain in the epigastric area, spreading to the back and intensifying after a meal. The disease is diagnosed in a complex way – by assessing risk factors, symptomatology, pancreatic function tests and radiological images. The diagnosis of the disease is easy in cases of advanced disease, but in the early stages it is often difficult to diagnose the disease due to the lack of radiological changes. Successful treatment of  CP requires a multidisciplinary approach. In particular, it is important to eliminate the factors that contribute to the progression of chronic pancreatitis (e.g., abstinence from alcohol, smoking, etc.). treatment is initiated by conservative methods: abdominal pain is relieved by lifestyle correction, medication. Endoscopic and surgical procedures are also performed to reduce the symptoms if medication is no longer effective or to achieve a long-term treatment effect, especially in reducing pain. Pancreatic enzyme therapy is indicated for the treatment of exocrine dysfunction. The most common complication -pancreatic pseudocysts, which are usually asymptomatic. The aim of this article is to review the etiological risk factors of chronic pancreatitis, the possibilities of modern diagnostics and the latest treatment recommendations based on the latest scientific literature. The object of the research is the topic of  CP in the publications published in scientific databases. The literature search was conducted in 2020 September-December in scientific databases: PubMed, UpToDate, ScienceDirect, and Clinical Key. Recent scientific articles were analyzed by keywords: chronic pancreatitis, diagnostic of chronic pancreatitis, treatment of chronic pancreatitis. Consistent methods of publication analysis based on a checklist of systematic literature review and meta-analysis were applied.

Keywords: chronic pancreatitis, diagnostic of chronic pancreatitis, treatment of chronic pancreatitis.