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  • Review Article
  • Published:

Treatment options for chronic pancreatitis

Nature Reviews Gastroenterology & Hepatology volume 11, pages 556–564 (2014)Cite this article

Subjects

Key Points

  • The treatment goals of chronic pancreatitis can roughly be divided into pain management, prevention and management of complications and improvement of pancreatic insufficiency

  • Surgery outperforms endoscopic treatment in late-stage obstructive chronic pancreatitis

  • Discoveries over the past few years in the fields of genetics and the microbiome have broadened our understanding of the pathogenesis of chronic and recurrent acute pancreatitis

Abstract

This Review covers the latest developments in the treatment options for chronic pancreatitis. Pain is the most frequent and dominant symptom in patients with chronic pancreatitis, which ranges from severe disabling continuous pain to mild pain attacks and pain-free periods. Conventional treatment strategies and recent changes in the treatment of pain in patients with chronic pancreatitis are outlined. The different treatment options for pain consist of medical therapy, endoscopy or surgery. Their related merits and drawbacks are discussed. Finally, novel insights in the field of genetics and microbiota are summarized, and future perspectives are discussed.

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Figure 1: Chronic pancreatitis.

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Acknowledgements

The authors acknowledge the work of the Dutch Pancreatitis Study Group.

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Authors and Affiliations

  1. Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands

    Yama Issa, Marc G. Besselink & Marja A. Boermeester

  2. Department of Gastroenterology & Hepatology, Erasmus Medical Center, University Medical Center, Rotterdam, 's Gravendijkwal 230, 3015 CE, Rotterdam, Netherlands

    Marco J. Bruno & Nicolien J. Schepers

  3. Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, Netherlands

    Olaf J. Bakker & Hjalmar C. van Santvoort

  4. Department of Operation Rooms/Evidence Based Surgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, PO Box 9101, 6500 HB, Nijmegen, Netherlands

    Hein G. Gooszen

Authors
  1. Yama Issa
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  2. Marco J. Bruno
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  3. Olaf J. Bakker
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  4. Marc G. Besselink
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  5. Nicolien J. Schepers
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  6. Hjalmar C. van Santvoort
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  7. Hein G. Gooszen
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  8. Marja A. Boermeester
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All authors contributed equally to all aspects of this manuscript.

Corresponding author

Correspondence to Marja A. Boermeester.

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The authors declare no competing financial interests.

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Issa, Y., Bruno, M., Bakker, O. et al. Treatment options for chronic pancreatitis. Nat Rev Gastroenterol Hepatol 11, 556–564 (2014). https://doi.org/10.1038/nrgastro.2014.74

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