Chronic pancreatitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Chronic pancreatitis is most commonly associated with chronic alcohol ingestion (>75%).
Hallmark features are epigastric abdominal pain radiating to the back, steatorrhea, malnutrition, and diabetes mellitus.
Diagnosis is based on clinical findings and imaging.
Underlying causes and precipitating factors should be treated. There is no definitive therapy; treatment is otherwise aimed at symptoms and complications.
Common complications include opioid addiction, pancreatic pseudocysts, pancreatic calcification, diabetes mellitus, and malabsorption.

Quick Reference

History & Exam
- Key Factors
- Other Factors
More information...
Diagnostics Tests
More information...
Treatment Options
More information...

Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Sherman S, Freeman ML, Tarnasky PR, et al. Administration of secretin (RG1068) increases the sensitivity of detection of duct abnormalities by magnetic resonance cholangiopancreatography in patients with pancreatitis. Gastroenterology. 2014;147:646-54.e2.[Abstract][Full Text]
Gurusamy KS, Lusuku C, Davidson BR. Pregabalin for decreasing pancreatic pain in chronic pancreatitis. Cochrane Database Syst Rev. 2016;(2):CD011522.[Abstract][Full Text]
Ahmed Ali U, Jens S, Busch OR, et al. Antioxidants for pain in chronic pancreatitis. Cochrane Database Syst Rev. 2014 Aug 21;(8):CD008945.[Abstract][Full Text]
Ahmed Ali U, Pahlplatz JM, Nealon WH, et al. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis. Cochrane Database Syst Rev. 2015 Mar 19;(3):CD007884.[Abstract][Full Text]
Gurusamy KS, Lusuku C, Halkias C, et al. Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis. Cochrane Database Syst Rev. 2016 Feb 3;(2):CD011521.[Abstract][Full Text]
Bachmann K, Tomkoetter L, Erbes J, et al. Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up. J Am Coll Surg. 2014 Aug;219(2):208-16.[Abstract]
Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med. 2007;356:676-84.[Abstract]

Referenced Articles

1. DiMagno EP, DiMagno MJ. Chronic pancreatitis: landmark papers, management decisions, and future. Pancreas. 2016 May-Jun;45(5):641-50.[Abstract]
2. Sarles H. Definitions and classifications of pancreatitis. Pancreas. 1991 Jul;6(4):470-4.[Abstract]
3. Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001 Feb;120(3):682-707.[Abstract]
4. Whitcomb DC, North American Pancreatitis Study Group. Pancreatitis: TIGAR-O version 2 risk/etiology checklist with topic reviews, updates, and use primers. Clin Transl Gastroenterol. 2019 Jun;10(6):e00027.[Abstract][Full Text]
5. Axon AT, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: international definitions. Gut. 1984 Oct;25(10):1107-12.[Abstract][Full Text]
6. Schneider A, Löhr JM, Singer MV. The M-ANNHEIM classification of chronic pancreatitis: introduction of a unifying classification system based on a review of previous classifications of the disease. J Gastroenterol. 2007 Feb;42(2):101-19.[Abstract]
7. Kamisawa T, Yoshiike M, Egawa N, et al. Chronic pancreatitis in the elderly in Japan. Pancreatology. 2004;4(3-4):223-7.[Abstract]
8. Okazaki K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006 Jul;41(7):626-31.[Abstract][Full Text]
9. Kawa S, Hamano H. Clinical features of autoimmune pancreatitis. J Gastroenterol. 2007 May;42 (Suppl 18):9-14.[Abstract]
10. Mullhaupt B, Truninger K, Ammann R. Impact of etiology on the painful early stage of chronic pancreatitis: a long-term prospective study. Z Gastroenterol. 2005 Dec;43(12):1293-301.[Abstract]
11. Layer P, Yamamoto H, Kalthoff L, et al. The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Gastroenterology. 1994 Nov;107(5):1481-7.[Abstract]
12. Lowenfels AB, Maisonneuve P, DiMagno EP, et al. Hereditary pancreatitis and the risk of pancreatic cancer: International Hereditary Pancreatitis Study Group. J Natl Cancer Inst. 1997 Mar 19;89(6):442-6.[Abstract]
13. Xiao AY, Tan ML, Wu LM, et al. Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol. 2016 Sep;1(1):45-55.[Abstract]
14. Machicado JD, Yadav D. Epidemiology of recurrent acute and chronic pancreatitis: similarities and differences. Dig Dis Sci. 2017 Jul;62(7):1683-91.[Abstract][Full Text]
15. Machicado JD, Rebours V, Yadav D. Epidemiology of chronic pancreatitis. Jul 2016 [internet publication].[Full Text]
16. Yadav D, Timmons L, Benson JT, et al. Incidence, prevalence, and survival of chronic pancreatitis: a population-based study. Am J Gastroenterol. 2011 Dec;106(12):2192-9.[Abstract]
17. Copenhagen pancreatitis study. An interim report from a prospective epidemiological multicentre study. Scand J Gastroenterol. 1981;16(2):305-12.[Abstract]
18. Sarles H. An international survey on nutrition and pancreatitis. Digestion. 1973;9(5):389-403.[Abstract]
19. Olsen TS. The incidence and clinical relevance of chronic inflammation in the pancreas in autopsy material. Acta Pathol Microbiol Scand A. 1978 Sep;86A(5):361-5.[Abstract]
20. Sankaran SJ, Xiao AY, Wu LM, et al. Frequency of progression from acute to chronic pancreatitis and risk factors: a meta-analysis. Gastroenterology. 2015 Nov;149(6):1490-500.[Abstract][Full Text]
21. Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019 Mar;16(3):175-84.[Abstract][Full Text]
22. James O, Agnew JE, Bouchier IA. Chronic pancreatitis in England: a changing picture? Br Med J. 1974 Apr 6;2(5909):34-8.[Abstract][Full Text]
23. Vege SS, Chari ST. Chronic pancreatitis. N Engl J Med. 2022 Mar 3;386(9):869-78.[Abstract]
24. Worning H. Chronic pancreatitis: pathogenesis, natural history and conservative treatment. Clin Gastroenterol. 1984 Sep;13(3):871-94.[Abstract]
25. Yadav D, Hawes RH, Brand RE, et al. Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009 Jun 8;169(11):1035-45.[Abstract]
26. Clark E. Pancreatitis in acute and chronic alcoholism. Am J Dig Dis. 1942;9:428.
27. DiMagno MJ. Oktoberfest binge drinking and acute pancreatitis: is there really no relationship? Clin Gastroenterol Hepatol. 2011 Nov;9(11):920-2.[Abstract]
28. Samokhvalov AV, Rehm J, Roerecke M. Alcohol consumption as a risk factor for acute and chronic pancreatitis: a systematic review and a series of meta-analyses. EBioMedicine. 2015 Nov 14;2(12):1996-2002.[Abstract][Full Text]
29. Durbec JP, Sarles H. Multicenter survey of the etiology of pancreatic diseases. Relationship between the relative risk of developing chronic pancreaitis and alcohol, protein and lipid consumption. Digestion. 1978;18(5-6):337-50.[Abstract]
30. Corrao G, Bahnardi V, Zambon A, et al. A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med. 2004 May;38(5):613-9.[Abstract]
31. Dufour MC, Adamson MD. The epidemiology of alcohol-induced pancreatitis. Pancreas. 2003 Nov;27(4):286-90.[Abstract]
32. Yadav D, Eigenbrodt ML, Briggs MJ, et al. Pancreatitis: prevalence and risk factors among male veterans in a detoxification program. Pancreas. 2007 May;34(4):390-8.[Abstract]
33. Lankisch PG, Lowenfels AB, Maisonneuve P. What is the risk of alcoholic pancreatitis in heavy drinkers? Pancreas. 2002 Nov;25(4):411-2.[Abstract]
34. Bourliere M, Barthet M, Berthezene P, et al. Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis? Gut. 1991 Nov;32(11):1392-5.[Abstract][Full Text]
35. Stigendal L, Olsson R. Alcohol consumption pattern and serum lipids in alcoholic cirrhosis and pancreatitis: a comparative study. Scand J Gastroenterol. 1984 Jul;19(5):582-7.[Abstract]
36. Wilson JS, Bernstein L, McDonald C, et al. Diet and drinking habits in relation to the development of alcoholic pancreatitis. Gut. 1985 Sep;26(9):882-7.[Abstract][Full Text]
37. DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2006 Sep;22(5):487-97.[Abstract]
38. Ockenga J, Vogel A, Teich N, et al. UDP glucuronosyltransferase (UGT1A7) gene polymorphisms increase the risk of chronic pancreatitis and pancreatic cancer. Gastroenterology. 2003 Jun;124(7):1802-8.[Abstract]
39. Jerrells TR, Chapman N, Clemens DL. Animal model of alcoholic pancreatitis: role of viral infections. Pancreas. 2003 Nov;27(4):301-4.[Abstract]
40. Clemens DL, Jerrells TR. Ethanol consumption potentiates viral pancreatitis and may inhibit pancreas regeneration: preliminary findings. Alcohol. 2004 Jul;33(3):183-9.[Abstract]
41. Ostrowski SE, Reilly AA, Collins DN, et al. Progression or resolution of coxsackievirus B4-induced pancreatitis: a genomic analysis. J Virol. 2004 Aug;78(15):8229-37.[Abstract][Full Text]
42. DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2005 Sep;21(5):544-54.[Abstract]
43. Ammann RW, Muellhaupt B. Progression of alcoholic acute to chronic pancreatitis. Gut. 1994 Apr;35(4):552-6.[Abstract][Full Text]
44. Lankisch PG, Lohr-Happe A, Otto J, et al. Natural course in chronic pancreatitis: pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. Digestion. 1993;54(3):148-55.[Abstract]
45. Ammann RW, Muellhaupt B, Meyenberger C, et al. Alcoholic nonprogressive chronic pancreatitis: prospective long-term study of a large cohort with alcoholic acute pancreatitis (1976-1992). Pancreas. 1994 May;9(3):365-73.[Abstract]
46. Strate T, Bachmann K, Busch P, et al. Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial. Gastroenterology. 2008 May;134(5):1406-11.[Abstract]
47. Warshaw AL, Banks PA, Fernandez-Del Castillo C. AGA technical review: treatment of pain in chronic pancreatitis. Gastroenterology. 1998 Sep;115(3):765-76.[Abstract][Full Text]
48. Coté GA, Yadav D, Slivka A, et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2011 Mar;9(3):266-73.[Abstract][Full Text]
49. Talamini G, Bassi C, Falconi M, et al. Alcohol and smoking as risk factors in chronic pancreatitis and pancreatic cancer. Dig Dis Sci. 1999 Jul;44(7):1303-11.[Abstract]
50. Morton C, Klatsky AL, Udaltsova N. Smoking, coffee, and pancreatitis. Am J Gastroenterol. 2004 Apr;99(4):731-8.[Abstract]
51. Murthy SN, Dinoso VP, Jr., Clearfield HR, et al. Simultaneous measurement of basal pancreatic, gastric acid secretion, plasma gastrin, and secretin during smoking. Gastroenterology. 1977 Oct;73(4 Pt 1):758-61.[Abstract]
52. Bynum TE, Solomon TE, Johnson LR, et al. Inhibition of pancreatic secretion in man by cigarette smoking. Gut. 1972 May;13(5):361-5.[Abstract][Full Text]
53. Maisonneuve P, Lowenfels AB, Mullhaupt B, et al. Cigarette smoking accelerates progression of alcoholic chronic pancreatitis. Gut. 2005 Apr;54(4):510-4.[Abstract][Full Text]
54. Tolstrup JS, Kristiansen L, Becker U, et al. Smoking and risk of acute and chronic pancreatitis among women and men: a population-based cohort study. Arch Intern Med. 2009 Mar 23;169(6):603-9.[Abstract]
55. Gupte A, Goede D, Tuite R, et al. Chronic pancreatitis. BMJ. 2018 Jun 7;361:k2126.[Abstract]
56. Nøjgaard C, Becker U, Matzen P, et al. Progression from acute to chronic pancreatitis: prognostic factors, mortality, and natural course. Pancreas. 2011 Nov;40(8):1195-200.[Abstract]
57. Cavallini G, Talamini G, Vaona B, et al. Effect of alcohol and smoking on pancreatic lithogenesis in the course of chronic pancreatitis. Pancreas. 1994 Jan;9(1):42-6.[Abstract]
58. Nakamura Y, Ohmori T, Higuchi S, et al. Certain background factors exhibit an association with an increased risk for pancreatic calcification among Japanese male alcoholics. Pancreas. 2005 Oct;31(3):225-31.[Abstract]
59. DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2004 Sep;20(5):444-51.[Abstract]
60. Singh VK, Yadav D, Garg PK. Diagnosis and management of chronic pancreatitis: a review. JAMA. 2019 Dec 24;322(24):2422-34.[Abstract]
61. Pezzilli R, Morselli-Labate AM, Mantovani V, et al. Mutations of the CFTR gene in pancreatic disease. Pancreas. 2003 Nov;27(4):332-6.[Abstract]
62. Masamune A, Ariga H, Kume K, et al. Genetic background is different between sentinel and recurrent acute pancreatitis. J Gastroenterol Hepatol. 2011 Jun;26(6):974-8.[Abstract]
63. Aoun E, Muddana V, Papachristou GI, et al. SPINK1 N34S is strongly associated with recurrent acute pancreatitis but is not a risk factor for the first or sentinel acute pancreatitis event. Am J Gastroenterol. 2010 Feb;105(2):446-51.[Abstract]
64. Rosendahl J, Witt H, Szmola R, et al. Chymotrypsin C (CTRC) variants that diminish activity or secretion are associated with chronic pancreatitis. Nat Genet. 2008 Jan;40(1):78-82.[Abstract][Full Text]
65. Muddana V, Lamb J, Greer JB, et al. Association between calcium sensing receptor gene polymorphisms and chronic pancreatitis in a US population: role of serine protease inhibitor Kazal 1type and alcohol. World J Gastroenterol. 2008 Jul 28;14(28):4486-91.[Abstract][Full Text]
66. Felderbauer P, Hoffmann P, Einwächter H, et al. A novel mutation of the calcium sensing receptor gene is associated with chronic pancreatitis in a family with heterozygous SPINK1 mutations. BMC Gastroenterol. 2003 Nov 29;3:34.[Abstract][Full Text]
67. Whitcomb DC, LaRusch J, Krasinskas AM, et al. Common genetic variants in the CLDN2 and PRSS1-PRSS2 loci alter risk for alcohol-related and sporadic pancreatitis. Nat Genet. 2012 Dec;44(12):1349-54.[Abstract][Full Text]
68. Witt H, Beer S, Rosendahl J, et al. Variants in CPA1 are strongly associated with early onset chronic pancreatitis. Nat Genet. 2013 Oct;45(10):1216-20.[Abstract][Full Text]
69. Weiss FU, Schurmann C, Guenther A, et al. Fucosyltransferase 2 (FUT2) non-secretor status and blood group B are associated with elevated serum lipase activity in asymptomatic subjects, and an increased risk for chronic pancreatitis: a genetic association study. Gut. 2015 Apr;64(4):646-56.[Abstract]
70. Xu W, Hui C, Yu SS, et al. MicroRNAs and cystic fibrosis - an epigenetic perspective. Cell Biol Int. 2011 May;35(5):463-6.[Abstract]
71. Knowles MR, Durie PR. What is cystic fibrosis? N Engl J Med. 2002 Aug 8;347(6):439-42.[Abstract]
72. Groman JD, Meyer ME, Wilmott RW, et al. Variant cystic fibrosis phenotypes in the absence of CFTR mutations. N Engl J Med. 2002 Aug 8;347(6):401-7.[Abstract][Full Text]
73. Ko SB, Mizuno N, Yatabe Y, et al. Corticosteroids correct aberrant CFTR localization in the duct and regenerate acinar cells in autoimmune pancreatitis. Gastroenterology. 2010 May;138(5):1988-96.[Abstract][Full Text]
74. Krier J, Barfield R, Green RC, et al. Reclassification of genetic-based risk predictions as GWAS data accumulate. Genome Med. 2016 Feb 17;8(1):20.[Abstract][Full Text]
75. Garrett LT, Hickman N, Jacobson A, et al. Family studies for classification of variants of uncertain classification: current laboratory clinical practice and a new web-based educational tool. J Genet Couns. 2016 Dec;25(6):1146-56.[Abstract][Full Text]
76. Moghadasi S, Eccles DM, Devilee P, et al. Classification and clinical management of variants of uncertain significance in high penetrance cancer predisposition genes. Hum Mutat. 2016 Apr;37(4):331-6.[Abstract][Full Text]
77. Sadr-Azodi O, Sanders DS, Murray JA, et al. Patients with celiac disease have an increased risk for pancreatitis. Clin Gastroenterol Hepatol. 2012 Oct;10(10):1136-42.[Abstract][Full Text]
78. Ludvigsson JF, Montgomery SM, Ekbom A. Risk of pancreatitis in 14,000 individuals with celiac disease. Clin Gastroenterol Hepatol. 2007 Nov;5(11):1347-53.[Abstract][Full Text]
79. Patel RS, Johlin FC Jr, Murray JA. Celiac disease and recurrent pancreatitis. Gastrointest Endosc. 1999 Dec;50(6):823-7.[Abstract]
80. Chiu HY, Hsieh CF, Chiang YT, et al. The risk of chronic pancreatitis in patients with psoriasis: a population-based cohort study. PLoS One. 2016 Jul 28;11(7):e0160041.[Abstract][Full Text]
81. DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2011 Sep;27(5):452-9.[Abstract][Full Text]
82. Dominguez-Munoz JE, Drewes AM, Lindkvist B, et al. Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis. Pancreatology. 2018 Dec;18(8):847-54.[Abstract]
83. Jalal M, Campbell JA, Hopper AD. Practical guide to the management of chronic pancreatitis. Frontline Gastroenterol. 2019 Jul;10(3):253-60.[Abstract]
84. Whitcomb DC, Buchner AM, Forsmark CE. AGA Clinical practice update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency: expert review. Gastroenterology. 2023 Nov;165(5):1292-301.[Abstract][Full Text]
85. Gardner TB, Adler DG, Forsmark CE, et al. ACG clinical guideline: chronic pancreatitis. Am J Gastroenterol. 2020 Mar;115(3):322-39.[Abstract]
86. Ahmed Ali U, Issa Y, Hagenaars JC, et al. Risk of recurrent pancreatitis and progression to chronic pancreatitis after a first episode of acute pancreatitis. Clin Gastroenterol Hepatol. 2016 May;14(5):738-46.[Abstract]
87. Garg PK, Tandon RK, Madan K. Is biliary microlithiasis a significant cause of idiopathic recurrent acute pancreatitis? A long-term follow-up study. Clin Gastroenterol Hepatol. 2007 Jan;5(1):75-9.[Abstract]
88. Jacob L, Geenen JE, Catalano MF, et al. Prevention of pancreatitis in patients with idiopathic recurrent pancreatitis: a prospective nonblinded randomized study using endoscopic stents. Endoscopy. 2001 Jul;33(7):559-62.[Abstract]
89. Yusoff IF, Raymond G, Sahai AV. A prospective comparison of the yield of EUS in primary vs recurrent idiopathic acute pancreatitis. Gastrointest Endosc. 2004 Nov;60(5):673-8.[Abstract]
90. Scott J, Summerfield JA, Elias E, et al. Chronic pancreatitis: a cause of cholestasis. Gut. 1977 Mar;18(3):196-201.[Abstract][Full Text]
91. Meier R, Ockenga J, Pertkiewicz M, et al. ESPEN guidelines on enteral nutrition: pancreas. Clin Nutr. 2006 Apr;25(2):275-84.[Abstract][Full Text]
92. Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer: International Pancreatitis Study Group. N Engl J Med. 1993 May 20;328(20):1433-7.[Abstract][Full Text]
93. Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000 Nov;119(5):1324-32.[Abstract]
94. Pan J, Xin L, Wang D, et al. Risk factors for diabetes mellitus in chronic pancreatitis: a cohort of 2,011 patients. Medicine (Baltimore). 2016 Apr;95(14):e3251.[Abstract][Full Text]
95. Sikkens EC, Cahen DL, Koch AD, et al. The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. Pancreatology. 2013 May-Jun;13(3):238-42.[Abstract]
96. Duggan SN, Smyth ND, O'Sullivan M, et al. The prevalence of malnutrition and fat-soluble vitamin deficiencies in chronic pancreatitis. Nutr Clin Pract. 2014 Jun;29(3):348-54.[Abstract]
97. Duggan SN, Purcell C, Kilbane M, et al. An association between abnormal bone turnover, systemic inflammation, and osteoporosis in patients with chronic pancreatitis: a case-matched study. Am J Gastroenterol. 2015 Feb;110(2):336-45.[Abstract]
98. Tignor AS, Wu BU, Whitlock TL, et al. High prevalence of low-trauma fracture in chronic pancreatitis. Am J Gastroenterol. 2010 Dec;105(12):2680-6.[Abstract]
99. Duggan SN, Smyth ND, Murphy A, et al. High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014 Feb;12(2):219-28.[Abstract]
100. Bang UC, Benfield T, Bendtsen F, et al. The risk of fractures among patients with cirrhosis or chronic pancreatitis. Clin Gastroenterol Hepatol. 2014 Feb;12(2):320-6.[Abstract]
101. Lu CL, Chen CY, Luo JC, et al. Impaired gastric myoelectricity in patients with chronic pancreatitis: role of maldigestion. World J Gastroenterol. 2005 Jan 21;11(3):372-6.[Abstract][Full Text]
102. Chowdhury RS, Forsmark CE, Davis RH, et al. Prevalence of gastroparesis in patients with small duct chronic pancreatitis. Pancreas. 2003 Apr;26(3):235-8.[Abstract]
103. Regan PT, Malagelada JR, DiMagno EP, et al. Postprandial gastric function in pancreatic insufficiency. Gut. 1979 Mar;20(3):249-54.[Abstract][Full Text]
104. Long WB, Weiss JB. Rapid gastric emptying of fatty meals in pancreatic insufficiency. Gastroenterology. 1974 Nov;67(5):920-5.[Abstract]
105. Mizushima T, Ochi K, Ichimura M, et al. Pancreatic enzyme supplement improves dysmotility in chronic pancreatitis patients. J Gastroenterol Hepatol. 2004 Sep;19(9):1005-9.[Abstract]
106. Carasso S, Oren I, Alroy G, et al. Disseminated fat necrosis with asymptomatic pancreatitis: a case report and review of the literature. Am J Med Sci. 2000 Jan;319(1):68-72.[Abstract]
107. Lucas PF, Owen TK. Subcutaneous fat necrosis, 'polyarthritis', and pancreatic disease. Gut. 1962 Jun;3:146-8.[Abstract][Full Text]
108. Bank S, Marks IN, Farman J, et al. Further observations on calcified medullary bone lesions in chronic pancreatitis. Gastroenterology. 1966 Aug;51(2):224-30.[Abstract]
109. Ichikawa T, Nakao K, Hamasaki K, et al. An autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis. World J Gastroenterol. 2005 Apr 7;11(13):2032-4.[Abstract][Full Text]
110. ASGE Standards of Practice Committee., Forbes N, Coelho-Prabhu N, et al. Adverse events associated with EUS and EUS-guided procedures. Gastrointest Endosc. 2022 Jan;95(1):16-26.e2.[Abstract]
111. Sherman S, Freeman ML, Tarnasky PR, et al. Administration of secretin (RG1068) increases the sensitivity of detection of duct abnormalities by magnetic resonance cholangiopancreatography in patients with pancreatitis. Gastroenterology. 2014;147:646-54.e2.[Abstract][Full Text]
112. DiMagno EP, Malagelada JR, Taylor WF, et al. A prospective comparison of current diagnostic tests for pancreatic cancer. N Engl J Med. 1977 Oct 6;297(14):737-42.[Abstract]
113. Bozkurt T, Braun U, Leferink S, et al. Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis. Gut. 1994 Aug;35(8):1132-6.[Abstract][Full Text]
114. Otsuki M. Chronic pancreatitis. The problems of diagnostic criteria. Pancreatology. 2004;4(1):28-41.[Abstract]
115. DiMagno MJ. Pancreatic function tests. In: Johnson LR, Alpers D, Barrett K, et al, eds. Encyclopedia of gastroenterology. 1st ed. Philadelphia, PA: Elsevier Science; 2003.
116. Rebours V, Le Baleur Y, Cazals-Hatem D, et al. Immunoglobulin G4 immunostaining of gastric, duodenal, or colonic biopsies is not helpful for the diagnosis of autoimmune pancreatitis. Clin Gastroenterol Hepatol. 2012;10:91-4.[Abstract]
117. Moon SH, Kim MH, Park DH, et al. Is a 2-week steroid trial after initial negative workup for malignancy useful in differentiating autoimmune pancreatitis from pancreatic cancer? A prospective outcome study. Gut. 2008 Dec;57(12):1704-12.[Abstract]
118. Munigala S, Kanwal F, Xian H, et al. Increased risk of pancreatic adenocarcinoma after acute pancreatitis. Clin Gastroenterol Hepatol. 2014;12:1143-50.[Abstract][Full Text]
119. Munigala S, Kanwal F, Xian H, et al. New diagnosis of chronic pancreatitis: risk of missing an underlying pancreatic cancer. Am J Gastroenterol. 2014;109:1824-30.[Abstract]
120. Simundic AM, Bölenius K, Cadamuro J, et al. Joint EFLM-COLABIOCLI recommendation for venous blood sampling. Clin Chem Lab Med. 2018;56(12):2015-38.[Abstract]
121. Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis: summary of an international workshop on chronic pancreatitis. Pancreas. 1997 Apr;14(3):215-21.[Abstract]
122. Raimondo M, Imoto M, DiMagno EP. Rapid endoscopic secretin stimulation test and discrimination of chronic pancreatitis and pancreatic cancer from disease controls. Clin Gastroenterol Hepatol. 2003 Sep;1(5):397-403.[Abstract]
123. Homma T, Harada H, Koizumi M. Diagnostic criteria of chronic pancreatitis by the Japan Pancreas Society. Pancreas. 1997 Jul;15(1):14-5.[Abstract]
124. Ammann RW, Muellhaupt B. The natural history of pain in alcoholic chronic pancreatitis. Gastroenterology. 1999 May;116(5):1132-40.[Abstract]
125. Ammann RW, Akovbiantz A, Largiader F, et al. Course and outcome of chronic pancreatitis: longitudinal study of a mixed medical-surgical series of 245 patients. Gastroenterology. 1984 May;86(5 Pt 1):820-8.[Abstract]
126. Girdwood AH, Marks IN, Bornman PC, et al. Does progressive pancreatic insufficiency limit pain in calcific pancreatitis with duct stricture or continued alcohol insult? J Clin Gastroenterol. 1981 Sep;3(3):241-5.[Abstract]
127. Lankisch PG, Seidensticker F, Lohr-Happe A, et al. The course of pain is the same in alcohol- and nonalcohol-induced chronic pancreatitis. Pancreas. 1995 May;10(4):338-41.[Abstract]
128. Maluf-Filho F, Dotti CM, Halwan B, et al. An evidence-based consensus statement on the role and application of endosonography in clinical practice. Endoscopy. 2009 Nov;41(11):979-87.[Abstract]
129. Wallace MB, Hawes RH, Durkalski V, et al. The reliability of EUS for the diagnosis of chronic pancreatitis: interobserver agreement among experienced endosonographers. Gastrointest Endosc. 2001 Mar;53(3):294-9.[Abstract]
130. Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009 Jun;69(7):1251-61.[Abstract]
131. Struyvenberg MR, Martin CR, Freedman SD. Practical guide to exocrine pancreatic insufficiency - breaking the myths. BMC Med. 2017 Feb 10;15(1):29.[Abstract][Full Text]
132. Hahn JU, Kerner W, Maisonneuve P, et al. Low fecal elastase 1 levels do not indicate exocrine pancreatic insufficiency in type-1 diabetes mellitus. Pancreas. 2008 Apr;36(3):274-8.[Abstract]
133. Dumasy V, Delhaye M, Cotton F, et al. Fat malabsorption screening in chronic pancreatitis. Am J Gastroenterol. 2004 Jul;99(7):1350-4.[Abstract]
134. Walkowiak J, Lisowska A, Blask-Osipa A, et al. Acid steatocrit determination is not helpful in cystic fibrosis patients without or with mild steatorrhea. Pediatr Pulmonol. 2010 Mar;45(3):249-54.[Abstract]
135. Ketwaroo G, Brown A, Young B, et al. Defining the accuracy of secretin pancreatic function testing in patients with suspected early chronic pancreatitis. Am J Gastroenterol. 2013 Aug;108(8):1360-6.[Abstract]
136. DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2010 Sep;26(5):490-8.[Abstract]
137. Chari ST, Smyrk TC, Levy MJ, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006 Aug;4(8):1010-6.[Abstract]
138. Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011 Apr;40(3):352-8.[Abstract]
139. Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013 Sep;108(9):1400-15.[Abstract]
140. American Society for Clinical Pathology. Do not test for amylase in cases of suspected acute pancreatitis. Instead, test for lipase. Choosing Wisely. Sep 2016 [internet publication].[Full Text]
141. Zhang L, Chari S, Smyrk TC, et al. Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas. 2011 Nov;40(8):1172-9.[Abstract]
142. Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012 Feb;22(1):21-30.[Abstract]
143. Deshpande V, Gupta R, Sainani N, et al. Subclassification of autoimmune pancreatitis: a histologic classification with clinical significance. Am J Surg Pathol. 2011 Jan;35(1):26-35.[Abstract]
144. Hart PA, Levy MJ, Smyrk TC, et al. Clinical profiles and outcomes in idiopathic duct-centric chronic pancreatitis (type 2 autoimmune pancreatitis): the Mayo Clinic experience. Gut. 2016 Oct;65(10):1702-9.[Abstract]
145. Sah RP, Chari ST, Pannala R, et al. Differences in clinical profile and relapse rate of type 1 versus type 2 autoimmune pancreatitis. Gastroenterology. 2010 Jul;139(1):140-8.[Abstract]
146. Elmunzer BJ, Maranki JL, Gómez V, et al. ACG clinical guideline: Diagnosis and management of biliary strictures. Am J Gastroenterol. 2023 Mar 1;118(3):405-26.[Abstract][Full Text]
147. ASGE Standards of Practice Committee, Coelho-Prabhu N, Forbes N, et al. Adverse events associated with EGD and EGD-related techniques. Gastrointest Endosc. 2022 Sep;96(3):389-401.[Abstract][Full Text]
148. Storm AC, Fishman DS, Buxbaum JL, et al. American Society for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures. Gastrointest Endosc. 2022 Feb;95(2):207-15.[Abstract]
149. Tirkes T, Shah ZK, Takahashi N, et al. Reporting standards for chronic pancreatitis by using CT, MRI, and MR cholangiopancreatography: The consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer. Radiology. 2019 Jan;290(1):207-15.[Abstract][Full Text]
150. Muthusamy VR, Chandrasekhara V, Acosta RD, et al.; ASGE Standards of Practice Committee. The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointest Endosc. 2016 Jul;84(1):1-9.[Abstract][Full Text]
151. Muthusamy VR, Chandrasekhara V, Acosta RD, et al.; ASGE Standards of Practice Committee. The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections. Gastrointest Endosc. 2016 Mar;83(3):481-8.[Abstract][Full Text]
152. Chandrasekhara V, Chathadi KV, Acosta RD, et al.; ASGE Standards of Practice Committee. The role of endoscopy in benign pancreatic disease. Gastrointest Endosc. 2015 Aug;82(2):203-14.[Abstract][Full Text]
153. Conwell DL, Lee LS, Yadav D, et al. American Pancreatic Association practice guidelines in chronic pancreatitis: evidence-based report on diagnostic guidelines. Pancreas. 2014 Nov;43(8):1143-62.[Abstract][Full Text]
154. Hegyi P, Párniczky A, Lerch MM, et al. International consensus guidelines for risk factors in chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club. Pancreatology. 2020 Jun;20(4):579-85.[Abstract][Full Text]
155. Frøkjær JB, Akisik F, Farooq A, et al. Guidelines for the diagnostic cross sectional imaging and severity scoring of chronic pancreatitis. Pancreatology. 2018 Oct;18(7):764-73.[Abstract]
156. Zou WB, Ru N, Wu H, et al. Guidelines for the diagnosis and treatment of chronic pancreatitis in China (2018 edition). Hepatobiliary Pancreat Dis Int. 2019 Apr;18(2):103-9.[Abstract]
157. Delhaye M, Van Steenbergen W, Cesmeli E, et al. Belgian consensus on chronic pancreatitis in adults and children: statements on diagnosis and nutritional, medical, and surgical treatment. Acta Gastroenterol Belg. 2014 Mar;77(1):47-65.[Abstract]
158. Martínez J, Abad-González A, Aparicio JR, et al. The Spanish Pancreatic Club recommendations for the diagnosis and treatment of chronic pancreatitis: part 1 (diagnosis). Pancreatology. 2013 Jan-Feb;13(1):8-17.[Abstract]
159. Strum WJ. Abstinence in alcoholic chronic pancreatitis: effect on pain and outcome. J Clin Gastroenterol. 1995 Jan;20(1):37-41.[Abstract]
160. Trapnell JE. Chronic relapsing pancreatitis: a review of 64 cases. Br J Surg. 1979 Jul;66(7):471-5.[Abstract]
161. Bornman PC, Marks IN, Girdwood AH, et al. Is pancreatic duct obstruction or stricture a major cause of pain in calcific pancreatitis? Br J Surg. 1980 Jun;67(6):425-8.[Abstract]
162. Strate T, Taherpour Z, Bloechle C, et al. Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Ann Surg. 2005 Apr;241(4):591-8.[Abstract][Full Text]
163. Nordback I, Pelli H, Lappalainen-Lehto R, et al. The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology. 2009;136:848-855.[Abstract]
164. Han S, Patel B, Min M, et al. Quality of life comparison between smokers and non-smokers with chronic pancreatitis. Pancreatology. 2018 Apr;18(3):269-74.[Abstract][Full Text]
165. Samarasekera E, Mahammed S, Carlisle S, et al. Pancreatitis: summary of NICE guidance. BMJ. 2018 Sep 5;362:k3443.[Abstract]
166. Arvanitakis M, Ockenga J, Bezmarevic M, et al. ESPEN guideline on clinical nutrition in acute and chronic pancreatitis. Clin Nutr. 2020 Mar;39(3):612-31.[Abstract][Full Text]
167. Haaber AB, Rosenfalck AM, Hansen B, et al. Bone mineral metabolism, bone mineral density, and body composition in patients with chronic pancreatitis and pancreatic exocrine insufficiency. Int J Pancreatol. 2000 Feb;27(1):21-7.[Abstract]
168. Singh S, Midha S, Singh N, et al. Dietary counseling versus dietary supplements for malnutrition in chronic pancreatitis: a randomized controlled trial. Clin Gastroenterol Hepatol. 2008 Mar;6(3):353-9.[Abstract][Full Text]
169. Stanga Z, Giger U, Marx A, et al. Effect of jejunal long-term feeding in chronic pancreatitis. JPEN J Parenter Enteral Nutr. 2005;29:12-20.[Abstract]
170. O'Keefe SJ. Physiological response of the human pancreas to enteral and parenteral feeding. Curr Opin Clin Nutr Metab Care. 2006 Sep;9(5):622-8.[Abstract]
171. Skipworth JR, Raptis DA, Wijesuriya S, et al. The use of nasojejunal nutrition in patients with chronic pancreatitis. JOP. 2011 Nov 9;12(6):574-80.[Abstract]
172. Taylor JR, Gardner TB, Waljee AK, et al. Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency. Aliment Pharmacol Ther. 2010;31:57-72.[Abstract]
173. Slaff J, Jacobson D, Tillman CR, et al. Protease-specific suppression of pancreatic exocrine secretion. Gastroenterology. 1984;87:44-52.[Abstract]
174. Ramo OJ, Puolakkainen PA, Seppala K, et al. Self-administration of enzyme substitution in the treatment of exocrine pancreatic insufficiency. Scand J Gastroenterol. 1989;24:688-92.[Abstract]
175. Isaksson G, Ihse I. Pain reduction by an oral pancreatic enzyme preparation in chronic pancreatitis. Dig Dis Sci. 1983;28:97-102.[Abstract]
176. Duggan SN, Conlon KC. A practical guide to the nutritional management of chronic pancreatitis. Practical Gastroenterology. 2013:24-32.[Full Text]
177. Wilder-Smith CH, Hill L, Osler W, et al. Effect of tramadol and morphine on pain and gastrointestinal motor function in patients with chronic pancreatitis. Dig Dis Sci. 1999;44:1107-16.[Abstract]
178. Gilron I, Bailey JM, Tu D, et al. Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial. Lancet. 2009 Oct 10;374(9697):1252-61.[Abstract]
179. Olesen SS, Bouwense SA, Wilder-Smith OH, et al. Pregabalin reduces pain in patients with chronic pancreatitis in a randomized, controlled trial. Gastroenterology. 2011;141:536-43.[Abstract]
180. Gurusamy KS, Lusuku C, Davidson BR. Pregabalin for decreasing pancreatic pain in chronic pancreatitis. Cochrane Database Syst Rev. 2016;(2):CD011522.[Abstract][Full Text]
181. Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology. 2009 Jan;136(1):149-59.[Abstract]
182. Siriwardena AK, Mason JM, Sheen AJ, et al. Antioxidant therapy does not reduce pain in patients with chronic pancreatitis: the ANTICIPATE study. Gastroenterology. 2012 Sep;143(3):655-63.[Abstract]
183. Ahmed Ali U, Jens S, Busch OR, et al. Antioxidants for pain in chronic pancreatitis. Cochrane Database Syst Rev. 2014 Aug 21;(8):CD008945.[Abstract][Full Text]
184. Rustagi T, Njei B. Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis. Pancreas. 2015 Jul;44(5):812-8.[Abstract]
185. Strand DS, Law RJ, Yang D, et al. AGA Clinical practice update on the endoscopic approach to recurrent acute and chronic pancreatitis: Expert review. Gastroenterology. 2022 Oct;163(4):1107-14.[Abstract][Full Text]
186. Madsen P, Hansen E. Coeliac plexus block versus pancreaticogastrostomy for pain in chronic pancreatitis. A controlled randomized trial. Scand J Gastroenterol. 1985 Dec;20(10):1217-20.[Abstract]
187. Gress F, Schmitt C, Sherman S, et al. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999 Apr;94(4):900-5.[Abstract]
188. Puli SR, Reddy JB, Bechtold ML, et al. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci. 2009 Nov;54(11):2330-7.[Abstract]
189. Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010 Feb;44(2):127-34.[Abstract]
190. Santosh D, Lakhtakia S, Gupta R, et al. Clinical trial: a randomized trial comparing fluoroscopy guided percutaneous technique vs. endoscopic ultrasound guided technique of coeliac plexus block for treatment of pain in chronic pancreatitis. Aliment Pharmacol Ther. 2009;29:979-84.[Abstract][Full Text]
191. Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290-5.[Abstract]
192. Thompson GE, Moore DC, Bridenbaugh LD, et al. Abdominal pain and alcohol celiac plexus nerve block. Anesth Analg. 1977;56:1-5.[Abstract]
193. Fujii LL, Topazian MD, Abu Dayyeh BK, et al. EUS-guided pancreatic duct intervention: outcomes of a single tertiary-care referral center experience. Gastrointest Endosc. 2013 Dec;78(6):854-64.[Abstract]
194. Moole H, Jaeger A, Bechtold ML, et al. Success of extracorporeal shock wave lithotripsy in chronic calcific pancreatitis management: a meta-analysis and systematic review. Pancreas. 2016 May-Jun;45(5):651-8.[Abstract]
195. Gurusamy KS, Pallari E, Hawkins N, et al. Management strategies for pancreatic pseudocysts. Cochrane Database Syst Rev. 2016;(4):CD011392.[Abstract][Full Text]
196. Newell KA, Liu T, Aranha GV, et al. Are cystgastrostomy and cystjejunostomy equivalent operations for pancreatic pseudocysts? Surgery. 1990 Oct;108(4):635-9.[Abstract]
197. Cahen DL, Rauws EA, Fockens P, et al. Endoscopic drainage of pancreatic pseudocysts: long-term outcome and procedural factors associated with safe and successful treatment. Endoscopy. 2005 Oct;37(10):977-83.[Abstract]
198. Nealon WH, Walser E. Surgical management of complications associated with percutaneous and/or endoscopic management of pseudocyst of the pancreas. Ann Surg. 2005 Jun;241(6):948-57.[Abstract]
199. Costamagna G, Pandolfi M, Mutignani M, et al. Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents. Gastrointest Endosc. 2001 Aug;54(2):162-8.[Abstract]
200. Catalano MF, Linder JD, George S, et al. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: comparison of single vs. multiple simultaneous stents. Gastrointest Endosc. 2004 Dec;60(6):945-52.[Abstract]
201. Cahen DL, van Berkel AM, Oskam D, et al. Long-term results of endoscopic drainage of common bile duct strictures in chronic pancreatitis. Eur J Gastroenterol Hepatol. 2005 Jan;17(1):103-8.[Abstract]
202. Shen Y, Liu M, Chen M, et al. Covered metal stent or multiple plastic stents for refractory pancreatic ductal strictures in chronic pancreatitis: a systematic review. Pancreatology. 2014 Mar-Apr;14(2):87-90.[Abstract]
203. Haapamäki C, Kylänpää L, Udd M, et al. Randomized multicenter study of multiple plastic stents vs. covered self-expandable metallic stent in the treatment of biliary stricture in chronic pancreatitis. Endoscopy. 2015 Jul;47(7):605-10.[Abstract]
204. Ahmed Ali U, Pahlplatz JM, Nealon WH, et al. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis. Cochrane Database Syst Rev. 2015 Mar 19;(3):CD007884.[Abstract][Full Text]
205. Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis. Ann Surg. 2010 Jan;251(1):18-32.[Abstract]
206. Smith MD, Degiannis E, Vickers SM. Surgery for chronic pancreatitis. In: Forsmark CE, ed. Pancreatitis and its complications. Vol 1. New York, NY: Humana Press, Inc; 2005:273-94.
207. Ahmed Ali U, Nieuwenhuijs VB, van Eijck CH, et al; Dutch Pancreatitis Study Group. Clinical outcome in relation to timing of surgery in chronic pancreatitis: a nomogram to predict pain relief. Arch Surg. 2012;147:925-32.[Abstract]
208. Bradley EL, Clements JL, Jr., Gonzalez AC. The natural history of pancreatic pseudocysts: a unified concept of management. Am J Surg. 1979 Jan;137(1):135-41.[Abstract]
209. Imrie CW, Buist LJ, Shearer MG. Importance of cause in the outcome of pancreatic pseudocysts. Am J Surg. 1988 Sep;156(3 Pt 1):159-62.[Abstract]
210. Aghdassi A, Mayerle J, Kraft M, et al. Diagnosis and treatment of pancreatic pseudocysts in chronic pancreatitis. Pancreas. 2008 Mar;36(2):105-12.[Abstract]
211. Snape WJ, Jr., Long WB, Trotman BW, et al. Marked alkaline phosphatase elevation with partial common bile duct obstruction due to calcific pancreatitis. Gastroenterology. 1976 Jan;70(1):70-3.[Abstract]
212. Baron TH. Endoscopic therapy with multiple plastic stents for benign biliary strictures due to chronic calcific pancreatitis: the good, the bad, and the ugly. J Clin Gastroenterol. 2004 Feb;38(2):96-8.[Abstract]
213. Frey CF, Suzuki M, Isaji S. Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg. 1990 Jan-Feb;14(1):59-69.[Abstract]
214. Shemesh E, Czerniak A, Nass S, et al. Role of endoscopic retrograde cholangiopancreatography in differentiating pancreatic cancer coexisting with chronic pancreatitis. Cancer. 1990 Feb 15;65(4):893-6.[Abstract]
215. Traverso LW, Kozarek RA. Pancreatoduodenectomy for chronic pancreatitis: anatomic selection criteria and subsequent long-term outcome analysis. Ann Surg. 1997 Oct;226(4):429-35.[Abstract][Full Text]
216. Gurusamy KS, Lusuku C, Halkias C, et al. Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis. Cochrane Database Syst Rev. 2016 Feb 3;(2):CD011521.[Abstract][Full Text]
217. Izbicki JR, Bloechle C, Knoefel WT, et al. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis: a prospective, randomized trial. Ann Surg. 1995 Apr;221(4):350-8.[Abstract][Full Text]
218. Bachmann K, Tomkoetter L, Erbes J, et al. Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up. J Am Coll Surg. 2014 Aug;219(2):208-16.[Abstract]
219. Diener MK, Rahbari NN, Fischer L, et al. Duodenum-preserving pancreatic head resection versus pancreatoduodenectomy for surgical treatment of chronic pancreatitis: a systematic review and meta-analysis. Ann Surg. 2008;247:950-61.[Abstract]
220. Dimagno MJ, Dimagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2012 Sep;28(5):523-31.[Abstract][Full Text]
221. Bellin MD, Freeman ML, Gelrud A, et al; PancreasFest Recommendation Conference Participants. Total pancreatectomy and islet autotransplantation in chronic pancreatitis: recommendations from PancreasFest. Pancreatology. 2014 Jan-Feb;14(1):27-35.[Abstract][Full Text]
222. National Institute for Health and Care Excellence. Autologous pancreatic islet cell transplantation for improved glycaemic control after pancreatectomy. Sep 2008 [internet publication].[Full Text]
223. Mallet-Guy PA. Late and very late results of resections of the nervous system in the treatment of chronic relapsing pancreatitis. Am J Surg. 1983;145:234-8.[Abstract]
224. Stone HH, Chauvin EJ. Pancreatic denervation for pain relief in chronic alcohol associated pancreatitis. Br J Surg. 1990 Mar;77(3):303-5.[Abstract]
225. Baghdadi S, Abbas MH, Albouz F, et al. Systematic review of the role of thoracoscopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2008 Mar;22(3):580-8.[Abstract]
226. Buscher HC, Jansen JB, van Dongen R, et al. Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis. Br J Surg. 2002 Feb;89(2):158-62.[Abstract]
227. Maher JW, Johlin FC, Heitshusen D. Long-term follow-up of thoracoscopic splanchnicectomy for chronic pancreatitis pain. Surg Endosc. 2001 Jul;15(7):706-9.[Abstract]
228. Issa Y, Ahmed Ali U, Bouwense SA, et al. Preoperative opioid use and the outcome of thoracoscopic splanchnicectomy in chronic pancreatitis: a systematic review. Surg Endosc. 2014 Feb;28(2):405-12.[Abstract]
229. Lillemoe KD, Kaushal S, Cameron JL, et al. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg. 1999 May;229(5):693-8.[Abstract][Full Text]
230. Sledzianowski JF, Duffas JP, Muscari F, et al. Risk factors for mortality and intra-abdominal morbidity after distal pancreatectomy. Surgery. 2005 Feb;137(2):180-5.[Abstract]
231. Hutchins RR, Hart RS, Pacifico M, et al. Long-term results of distal pancreatectomy for chronic pancreatitis in 90 patients. Ann Surg. 2002 Nov;236(5):612-8.[Abstract][Full Text]
232. Rattner DW, Fernandez-del Castillo C, Warshaw AL. Pitfalls of distal pancreatectomy for relief of pain in chronic pancreatitis. Am J Surg. 1996 Jan;171(1):142-5.[Abstract]
233. Williamson RC, Cooper MJ. Resection in chronic pancreatitis. Br J Surg. 1987 Sep;74(9):807-12.[Abstract]
234. Graversen C, Olesen SS, Olesen AE, et al. The analgesic effect of pregabalin in patients with chronic pain is reflected by changes in pharmaco-EEG spectral indices. Br J Clin Pharmacol. 2012 Mar;73(3):363-72.[Abstract][Full Text]
235. Dite P, Ruzicka M, Zboril V, et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy. 2003;35:553-8.[Abstract]
236. Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med. 2007;356:676-84.[Abstract]
237. Cahen DL, Gouma DJ, Laramée P, et al. Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology. 2011;141:1690-5.[Abstract]
238. Ebbehoj N, Borly L, Bulow J, et al. Evaluation of pancreatic tissue fluid pressure and pain in chronic pancreatitis. A longitudinal study. Scand J Gastroenterol. 1990;25:462-6.[Abstract]
239. Fregni F, Potvin K, Dasilva D, et al. Clinical effects and brain metabolic correlates in non-invasive cortical neuromodulation for visceral pain. Eur J Pain. 2011 Jan;15(1):53-60.[Abstract][Full Text]
240. Guarner L, Navalpotro B, Molero X, et al. Management of painful chronic pancreatitis with single-dose radiotherapy. Am J Gastroenterol. 2009 Feb;104(2):349-55.[Abstract]
241. Juel J, Liguori S, Liguori A, et al. Acupuncture for pain in chronic pancreatitis: a single-blinded randomized crossover trial. Pancreas. 2017 Feb;46(2):170-6.[Abstract]
242. Ballegaard S, Christophersen SJ, Dawids SG, et al. Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis: a randomized study. Scand J Gastroenterol. 1985 Dec;20(10):1249-54.[Abstract]
243. National Institute for Health and Care Excellence. Pancreatitis. Dec 2020 [internet publication].[Full Text]
244. Dumonceau JM, Delhaye M, Tringali A, et al. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Updated August 2018. Endoscopy. 2019 Feb;51(2):179-93.[Abstract]
245. de-Madaria E, Abad-González A, Aparicio JR, et al. The Spanish Pancreatic Club's recommendations for the diagnosis and treatment of chronic pancreatitis: part 2 (treatment). Pancreatology. 2013 Jan-Feb;13(1):18-28.[Abstract]
246. Dumonceau JM, Tringali A, Blero D, et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2012 Mar;44(3):277-98.[Abstract]
247. Seicean A, Tantau M, Grigorescu M, et al. Mortality risk factors in chronic pancreatitis. J Gastrointestin Liver Dis. 2006 Mar;15(1):21-6.[Abstract]
248. WHO Expert Committee on drug dependence. World Health Organ Tech Rep Ser. 1993;836:1-44.[Abstract]
249. Ward J, Hall W, Mattick RP. Role of maintenance treatment in opioid dependence. Lancet. 1999 Jan 16;353(9148):221-6.[Abstract]
250. Sees KL, Delucchi KL, Masson C, et al. Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence: a randomized controlled trial. JAMA. 2000 Mar 8;283(10):1303-10.[Abstract]
251. Fischer G, Gombas W, Eder H, et al. Buprenorphine versus methadone maintenance for the treatment of opioid dependence. Addiction. 1999 Sep;94(9):1337-47.[Abstract]
252. Aranha GV, Prinz RA, Esguerra AC, et al. The nature and course of cystic pancreatic lesions diagnosed by ultrasound. Arch Surg. 1983 Apr;118(4):486-8.[Abstract]
253. Gouyon B, Levy P, Ruszniewski P, et al. Predictive factors in the outcome of pseudocysts complicating alcoholic chronic pancreatitis. Gut. 1997 Dec;41(6):821-5.[Abstract][Full Text]
254. Sankaran S, Walt AJ. The natural and unnatural history of pancreatic pseudocysts. Br J Surg. 1975 Jan;62(1):37-44.[Abstract]
255. Castles LA, Terblanche J. Pancreatic ascites and pleural effusions. Aust N Z J Surg. 1978 Jun;48(3):290-5.[Abstract]
256. Donowitz M, Kerstein MD, Spiro HM. Pancreatic ascites. Medicine (Baltimore). 1974 May;53(3):183-95.[Abstract]
257. Runyon BA. Amylase levels in ascitic fluid. J Clin Gastroenterol. 1987 Apr;9(2):172-4.[Abstract]
258. Cameron JL. Chronic pancreatic ascites and pancreatic pleural effusions. Gastroenterology. 1978 Jan;74(1):134-40.[Abstract]
259. Segal I, Parekh D, Lipschitz J, et al. Treatment of pancreatic ascites and external pancreatic fistulas with a long-acting somatostatin analogue (Sandostatin). Digestion. 1993;54 (Suppl 1):53-8.[Abstract]
260. Oktedalen O, Nygaard K, Osnes M. Somatostatin in the treatment of pancreatic ascites. Gastroenterology. 1990 Nov;99(5):1520-1.[Abstract]
261. Pai CG, Suvarna D, Bhat G. Endoscopic treatment as first-line therapy for pancreatic ascites and pleural effusion. J Gastroenterol Hepatol. 2009 Jul;24(7):1198-202.[Abstract]
262. Lakhtakia S, Reddy DN. Pancreatic leaks: endo-therapy first? J Gastroenterol Hepatol. 2009 Jul;24(7):1158-60.[Abstract][Full Text]
263. Rosch J, Herfort K. Contribution of splenoportography to the diagnosis of diseases of the pancreas. II. Inflammatory diseases. Acta Med Scand. 1962 Mar;171:263-72.[Abstract]
264. Sakorafas GH, Sarr MG, Farley DR, et al. The significance of sinistral portal hypertension complicating chronic pancreatitis. Am J Surg. 2000 Feb;179(2):129-33.[Abstract]
265. Bernades P, Baetz A, Levy P, et al. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients. Dig Dis Sci. 1992 Mar;37(3):340-6.[Abstract]
266. Usatoff V, Brancatisano R, Williamson RC. Operative treatment of pseudocysts in patients with chronic pancreatitis. Br J Surg. 2000 Nov;87(11):1494-9.[Abstract]
267. Kumar K, Ghoshal UC, Srivastava D, et al. Small intestinal bacterial overgrowth is common both among patients with alcoholic and idiopathic chronic pancreatitis. Pancreatology. 2014 Jul-Aug;14(4):280-3.[Abstract]
268. Campisi A, Brancatelli G, Vullierme MP, et al. Are pancreatic calcifications specific for the diagnosis of chronic pancreatitis? A multidetector-row CT analysis. Clin Radiol. 2009 Sep;64(9):903-11.[Abstract]
269. Afroudakis A, Kaplowitz N. Extrahepatic obstruction in chronic alcoholic pancreatitis. Alcohol Clin Exp Res. 1981 Jan;5(1):110-8.[Abstract]
270. Hammel P, Couvelard A, O'Toole D, et al. Regression of liver fibrosis after biliary drainage in patients with chronic pancreatitis and stenosis of the common bile duct. N Engl J Med. 2001 Feb 8;344(6):418-23.[Abstract][Full Text]
271. Talamini G, Falconi M, Bassi C, et al. Incidence of cancer in the course of chronic pancreatitis. Am J Gastroenterol. 1999 May;94(5):1253-60.[Abstract]
272. Karlson BM, Ekbom A, Josefsson S, et al. The risk of pancreatic cancer following pancreatitis: an association due to confounding? Gastroenterology. 1997 Aug;113(2):587-92.[Abstract]
273. Aslanian HR, Lee JH, Canto MI. AGA Clinical practice update on pancreas cancer screening in high-risk individuals: expert review. Gastroenterology. 2020 Jul;159(1):358-62.[Abstract][Full Text]
274. Greenhalf W, Lévy P, Gress T, et al. International consensus guidelines on surveillance for pancreatic cancer in chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club. Pancreatology. 2020 Jul;20(5):910-8.[Abstract]
275. National Institute for Health and Care Excellence. Pancreatic cancer in adults: diagnosis and management. Feb 2018 [internet publication].[Full Text]
276. Qian YY, Ru N, Chen H, et al. Rectal indometacin to prevent pancreatitis after extracorporeal shock wave lithotripsy (RIPEP): a single-centre, double-blind, randomised, placebo-controlled trial. Lancet Gastroenterol Hepatol. 2022 Mar;7(3):238-44.[Abstract]