Chronic Pancreatitis

Chronic pancreatitis (CP) is characterized by recurrent inflammation resulting in progressive and irreversible disease of the pancreas. Abdominal pain is the predominant symptom attributable to ductal hypertension, inflammation, nerve ischemia, and entrapment. Diagnosis is based on imaging studies like USG, CECT, and MRI-MRCP. CT scan and MRI provide complete morphology of the gland and the pancreatic duct, a prerequisite to planning surgery. Management of CP is directed at the control of pain and the management of complications. Medical management precedes interventional management and comprises analgesics and antioxidants. Interventional treatment, endoscopic or surgical, is required in 40–75% of patients. Endoscopic treatment is contraindicated in multiple or long pancreatic duct strictures. It comprises transpapillary dilatation of MPD strictures, stone extraction, and stenting. Lithotripsy may be required to fragment large stones to facilitate extraction. Surgery provides better long-term outcomes than endoscopic treatment.