■慢性胰腺炎是一种异质性和复杂的综合征,在大多数情况下,导致疼痛作为主要症状,并影响胰腺的形态和功能,导致几个严重的并发症。
■本综述,基于更新至2023年6月的非系统PubMed搜索,旨在提供当前现有证据,证明胃肠病学家在通过内窥镜或药物治疗诊断和治疗局部和全身并发症方面的作用.
■在诊断和慢性胰腺炎随访期间,需要特别注意,不仅要考虑疾病的临床表现和症状,如疼痛,黄疸,胃肠道梗阻,和假性囊肿,这需要多学科的讨论,以建立最佳的治疗方案(内窥镜或手术),但也不太明显的全身并发症。胰腺外分泌和内分泌功能不全,加上慢性炎症,上瘾,和生态失调,导致营养不良,少肌症,和骨病。这些并发症,反过来,增加感染的风险,血栓栓塞事件,和死亡。慢性胰腺炎患者患精神疾病和胰腺癌的风险也增加。总的来说,慢性胰腺炎患者应接受整体评估,考虑到所有这些方面,可能通过专门的专家中心的多学科护理。
UNASSIGNED: Chronic pancreatitis is a heterogeneous and complex syndrome that, in most cases, causes pain as a cardinal symptom and affects both the morphology and function of the pancreas, leading to several serious complications.
UNASSIGNED: The present review, based on a non-systematic PubMed search updated to June 2023, aims to present the current available evidence on the role of gastroenterologists in the diagnosis and treatment of both local and systemic complications by either endoscopic or medical treatments.
UNASSIGNED: At diagnosis and during chronic pancreatitis follow-up, particular care is needed to consider not only the clinically manifest signs and symptoms of the disease, such as pain, jaundice, gastrointestinal obstruction, and pseudocysts, which require multidisciplinary discussion to establish the best treatment option (endoscopic or surgical), but also less evident systemic complications. Pancreatic exocrine and endocrine insufficiency, together with chronic inflammation, addiction, and dysbiosis, contribute to malnutrition, sarcopenia, and osteopathy. These complications, in turn, increase the risk of infection, thromboembolic events, and death. Patients with chronic pancreatitis also have an increased risk of psychiatric disorders and pancreatic cancer onset. Overall, patients with chronic pancreatitis should receive a holistic evaluation, considering all these aspects, possibly through multidisciplinary care in dedicated expert centers.