Guideline for the diagnosis and treatment of chronic pancreatitis

摘要: Background. Chronic pancreatitis (CP) is defined as a continuing inflammatory disease of the pancreas characterised by irreversible morphological changes, often associated with pain and loss exocrine and/or endocrine function that may be clinically relevant. Alcohol predominant cause CP in western world particularly prevalent South Africa, especially indigent patient. ranks high among intractable diseases gastrointestinal tract. The tendency for substance abuse alcohol-induced group poses major psychological socio-economic problems. Objective. significant clinical pathological heterogeneity. Level 1 evidence to support definitive guidelines diagnosis, medical management interventional therapy lacking. Despite this paucity robust scientific evidence, it important provide some assistance based on best available current standard care African context; will aid all involved disease, includes clinicians, health managers funders. Scope. were developed recommendations addressing interventions, both endoscopic surgical, very complex heterogeneous pancreas. are relevant context where patho-aetiological agents alcohol-associated smoking. Recommendations. clear regarding diagnostic modalities available, imaging (which MRI ultrasound (EUS)) pancreatic tests. section makes use analgesics, enzyme replacement other therapeutic options non-interventional majority patients CP. procedures identifies indications uncomplicated complicated role surgical defined, but combined experience group, influenced put forward. Owing lack complexity recommended that, possible, managed multidisciplinary team. Validation. practice principles determined opinions which comprised 7 gastroenterologists dealing chronic context. convened between May 2009 August 2010 under auspices Hepato-Pancreatico-Biliary Association Africa (HPBASA) Gastroenterology Society (SAGES), result broad consensus within group. draft was presented experts field endeavour ensure broader participation consensus. Plans guideline revision. HPBASA SAGES publish revised modification when new levels 2 data published.