Endoskopische und chirurgische Therapie der chronischen Pankreatitis

Mayerle, J.; Anz, D.; D'Haese, J. G. und Werner, J. (2019): Endoskopische und chirurgische Therapie der chronischen Pankreatitis. In: Internist, Bd. 60, Nr. 3: S. 235-246

Abstract

With an increasing number of hospital admissions, an average of 16-to 20days in hospital per year, 34% of patients constantly taking pain medication, 57% in need of enzyme supplementation, and 29% with diabetes mellitus, chronic pancreatitis is adebilitating disease of high socio-economic relevance. In total, 33% of all patients suffering from chronic pancreatitis can no longer practice their original profession. The number of unemployed chronic pancreatitis patients due to prolonged stays in hospital or continued alcohol abuse is known to be as high as 40%. Continued alcohol abuse with ahazard ratio (HR) of 1.6, smoking with aHR of 1.4, and the presence of liver cirrhosis with aHR of 2.5 negatively affects the prognosis of chronic pancreatitis. In apatient cohort burdened with high co-morbidity, endoscopic therapy can provide short-term relief of symptoms. Endotherapy is the first line of management in chronic pancreatitis with symptomatic pancreatobiliary ductal obstruction. Further studies are required in certain key areas such as the use of fully covered self-expanding metallic stents for pancreatic ductal and biliary strictures. Long-term success rates can mainly be achieved by surgical procedures, which can be performed with acceptable morbidity in pancreatic centers. The current review focuses on the advantages and disadvantages of endoscopic and surgical treatment of chronic pancreatitis.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0020-9554
• Sprache: Deutsch