| Popis: |
Optimal treatment of patients with chronic pancreatitis involves multidisciplinary strategies that integrate medical, endoscopic, and surgical forms of therapy. Pain relief is often the focus of therapy that has the greatest influence on quality of life, although attention to treatment of exocrine insufficiency and malnutrition are also important. When medical management fails, some patients may be candidates for endoscopic or surgical intervention. Endotherapy options include pancreatic duct stricture dilation, stent placement, and stone removal. In appropriately selected patients, endotherapy may achieve significant pain relief, although success may be relatively short lived and patients typically require multiple treatments. Surgical therapy is directed toward the presumed mechanism of pain, traditionally through internal pancreatic duct drainage (Roux-en-Y lateral pancreaticojejunostomy) or pancreatic head resection (pancreaticoduodenectomy or duodenum-sparing alternatives). Depending on patient selection, surgical therapy may achieve a long-term pain relief up to 80%. |
