Summary
The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.
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References
Ahmed SA, Wray C, Rilo HL, et al. Chronic pancreatitis: recent advances and ongoing challenges. Curr Probl Surg, 2006,43(3):127–238
Steer ML, Waxman I, Freedman S. Chronic pancreatitis. N Engl J Med, 1995,332(22):1482–1490
Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis: summary of an international workshop on chronic pancreatitis. Pancreas, 1997,14(3): 215–221
Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology, 2001,120(3):682–707
Stevens T, Conwell DL, Zuccaro G. Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments. Am J Gastroenterol, 2004,99(11): 2256–2270
Ammann RW, Heitz PU, Kloppel G. Course of alcoholic chronic pancreatitis: a prospective clinicomorphological long-term study. Gastroenterology, 1996,111(1):224–231
Neuhaus H. Therapeutic pancreatic endoscopy. Endoscopy, 2004,36(1):8–16
Baillie J. Endoscopic therapy in acute recurrent pancreatitis. World J Gastroenterol, 2008,14(7):1034–1037
Morgan DE, Logan K, Baron TH, et al. Pancreas divisum: implications for diagnostic and therapeutic pancreatography. Am J Roentgenol, 1999,173(1):193–198
Testoni PA, Caporuscio S, Bagnolo F, et al. Idiopathic recurrent pancreatitis: long-term results after ERCP, endoscopic sphincterotomy, or ursodeoxycholic acid treatment. Am J Gastroenterol, 2000,95(7):1702–1707
Johanson JF, Schmalz MJ, Geenen JE. Incidence and risk factors for biliary and pancreatic stent migration. Gastrointest Endosc, 1992,38(3):341–346
Maydeo A, Soehendra N, Reddy N, et al. Endotherapy for chronic pancreatitis with intracanalar stones. Endoscopy, 2007,39(7):653–658
Smith MT, Sherman S, Ikenberry SO, et al. Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy. Gastrointest Endosc, 1996,44(3):268–275
Mariani A, Testoni PA. Is acute recurrent pancreatitis a chronic disease? World J Gastroenterol, 2008,14(7):995–998
Gall FP, Muhe E, Gebhardt C. Results of partial and total pancreaticoduodenectomy in 117 patients with chronic pancreatitis. World J Surg, 1981,5(2):269–275
Beger HG, Krautzberger W, Bittner R, et al. Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 1985,97(4): 467–473
Wang C, Liu T, Wu H, et al. Duodenum-preserving total pancreatic head resection without segment resection of the duodenum for chronic pancreatitis. Langenbecks Arch Surg, 2009,394(3):563–568
Ammann RW, Muellhaupt B. The natural history of pain in alcoholic chronic pancreatitis. Gastroenterology, 1999, 116(5):1132–1140
Sprangers MA, Cull A, Bjordal K, et al. The European Organization for Research and Treatment of Cancer. Approach to quality of life assessment: guidelines for developing questionnaire modules. EORTC Study Group on Quality of Life. Qual Life Res, 1993,2(4):287–295
Osoba D, Rodrigues G, Myles J, et al. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol, 1998,16(1):139–144
Delhaye M, Matos C, Arvanitakis M, et al. Pancreatic ductal system obstruction and acute recurrent pancreatitis. World J Gastroenterol, 2008,14(7):1027–1033
Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med, 2007,356(20):676–684
Sarles H, Bernard JP, Gullo L. Pathogenesis of chronic pancreatitis. Gut, 1990,31(6):629–632
Ammann RW, Muellhaupt B. Progression of alcoholic acute to chronic pancreatitis. Gut, 1994,35(4):552–556
Freiburghaus AU, Redha F, Ammann RW. Does acute pancreatitis progress to chronic pancreatitis? A microvascular pancreatitis model in the rat. Pancreas, 1995,11(4):374–381
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Zhou, F., Gou, Sm., Xiong, Jx. et al. Surgical treatment of chronic pancreatitis in young patients. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 34, 701–705 (2014). https://doi.org/10.1007/s11596-014-1339-4
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DOI: https://doi.org/10.1007/s11596-014-1339-4