RT Book, Section
A1 Baker, Marshall S.
A1 Matthews, Jeffrey B.
A2 Zinner, Michael J.
A2 Ashley, Stanley W.
SR Print(0)
ID 57019808
T1 Chapter 56. Chronic Pancreatitis
T2 Maingot's Abdominal Operations, 12e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163388-8
LK accesssurgery.mhmedical.com/content.aspx?aid=57019808
RD 2024/04/25
AB Chronic  pancreatitis  is  an  inflammatory  and  fibrosing  disease  of  the  exocrine  pancreas  characterized  by  irreversible  morphological  changes  and  permanent  loss  of  function.  The  apparent  incidence  of  chronic  pancreatitis  has  increased  approximately  fourfold  over  the  past  several  decades,  likely  due  a  broadening  of  its  definition  and  the  inclusion  of  patients  with  earlier-stage  disease.  The  natural  history  of  chronic  pancreatitis  is  unpredictable.  Affected  individuals  typically  suffer  a  pattern  of  persistent  or  recurrent  attacks  of  pain  along  with  progressive  pancreatic  exocrine  insufficiency.  Symptoms  may  also  result  from  extension  of  the  disease  process  to  adjacent  organs  and  vascular  structures.  In  later  stages,  pancreatic  endocrine  insufficiency  may  develop.  Decision  making  in  the  management  of  chronic  pancreatitis  must  be  individualized  to  the  specific  anatomic  and  pathological  circumstances,  taking  into  account  the  extent  of  local  expertise  in  various  diagnostic  and  therapeutic  modalities  as  well  as  the  fact  that  there  is  a  relative  paucity  of  high-quality  data  on  the  clinical  effectiveness  of  surgical  and  medical  interventions.  Optimal  management  is  facilitated  by  a  multidisciplinary  approach  that  includes  surgical,  endoscopic,  and  radiological  expertise  in  addition  to  nutrition,  endocrinology,  pain  management,  and  psychosocial  support.