Overview
Chronic Pancreatitis is inflammation (swelling) of the pancreas that gets worse over time and leads to permanent damage. This eventually leads to progressive impairment of exocrine and endocrine function of the pancreas.
SIGNS & SYMPTOMS:
- Recurrent attacks of pain in upper abdomen (radiating to back)
- Worsening of pain abdomen after meals
- Unintentional loss of weight
- Foul smelling, oily stools (steatorrhea)
- Diabetes
CAUSES:
Most common causes in India include
- Chronic calcific pancreatitis for which no cause is determined (idiopathic)
- Excessive alcohol consumption.
- Other causes include:
- Certain medications
- High triglyceride levels (hypertriglyceridemia)
- High calcium levels (hypercalcemia)
- Pancreas cancer
TREATMENT:
- Pain management: Non-opioids, mild opioid medications or intervention such as celiac plexus block
- Endoscopy (ERCP): In patient with narrowing in the main pancreatic duct (stricture) ERCP may be helpful
- Surgery: When medical therapy fails, surgery is indicated
- Surgery is one time, low risk treatment that provides long lasting pain relief. Surgery performed early may help preserve pancreatic functions also. Surgery is also indicated for local complications of chronic pancreatitis such as obstruction of bile duct, duodenum.
Surgical options include
- Lateral Pancreaticojejunostomy (Modified Puestow procedure)
- Frey’s procedure
- Whipple’s procedure