Chronic pancreatitis: clinical and therapeutic study. Six years of experience of a gastroenterology department

Abstract

Background: The chronic pancreatitis is an inflammatory chronic affection of the pancreatic parenchyma characterized by a mutilating fibrosis with a progressive set up. The endoscopic treatment is actually considered as the first-line treatment and can sometimes be complementary to surgery.
Aim: To determine the epidemiological, clinical, para-clinical and therapeutic characteristics during chronic pancreatitis.
Methods: a retrospective study including patients having a chronic pancreatitis hospitalized in the gastroenterology department of Habib Thameur hospital between 2002 and 2008 was performed. Results: Sixteen patients were included in this study (mean age 43 years, sex ratio 7). All the patients were symptomatic at the time of the diagnosis and the epigastric pain was the main symptom. A complication was noted at the time of diagnosis in 12 patients: endocrine and exocrine pancreatic failure was noted in respectively 5 and 3 patients, while other complications were less frequent: acute pancreatitis (2 patients), cholestatic jaundice (2 patients) and pancreatic pseudo-cyst (2 patients). The endoscopic treatment was performed in 62% of the patients with success of 63%. The surgical treatment was indicated in 37% of the cases. Mean follow up was 16 months. Survival rate was 93% at one year. One patient died because of hypoglycemia. No pancreatic neoplasia was noted in our study.
Conclusion: In chronic pancreatitis, the contribution of endoscopic treatment is considerable but not without a certain risk. Therefore, collaboration between surgeons and endoscopists is needed and the best treatment should be considered individually.