GASTROENTEROLOGY ARTICLE OF THE WEEK
February 1, 2007
ASGE Guidelines. The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc 2006;63:933-937.
1. Pancreatic duct stones
a. May contribute to abdominal pain or acute pancreatitis in patients with CP
b. Pancreatic duct stones are relatively easy to removed via ERP
c. Endoscopic therapy for pancreatic duct stones yields superior results to surgery
d. Are a frequent cause of cholangitis
True or False
2. ERCP should be the next diagnostic test when chronic pancreatitis is suspected and CT/MRCP are non-diagnostic
3. EUS is able to detect parenchymal pancreatic changes but not ductal abnormalities
4. Endoscopic therapy using transpapillary stents is successful in closing pancreatic duct leaks in 60% of cases.
5. Endoscopic biliary stent placement is the treatment of choice for patients with biliary obstruction secondary to chronic pancreatitis
6. Dilation of main pancreatic duct strictures does not reliably result in improvement of pain
7. Placement of pancreatic duct stents is more likely to cause long-term damage in patients with advanced pancreatitis than when placed in those with early pancreatitis
8. Pancreatic pseudocysts should be drained if they measure > 8cm in diameter.
9. EUS-guided celiac plexus blockade results in improvement in only 50% of patients.