Best Practice & Research Clinical Gastroenterology
Volume 24, Issue 3 , Pages 323-335 , June 2010

Pain management in chronic pancreatitis: A treatment algorithm

  • Shailendra Chauhan (Assistant Professor of Medicine)
    • ,
  • Chris E. Forsmark (Professor of Medicine, Chief)

      Affiliations

    • Corresponding Author InformationCorresponding author. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, Room HD 602, 1600 SW Archer Rd, Gainesville, FL 32610-0214, United States. Tel.: +1 352 273 9400; fax: +1 352 392 3618.

References 

  1. Pezilli R, Morselli-labate AM, Fantini L, et al. Assessment of the quality of life in chronic pancreatitis using SF-12 and EORTC Q1q-C30 questionnaires. Dig Liv Dis. 2007;39:1077–1086
  2. Wehler M, Nichterlein R, Fischer B, et al. Factors associated with health-related quality of life in chronic pancreatitis. Am J Gastroenterol. 2004;99:138–146
  3. Witt H, Apte MV, Keim V, Wilson JS. Chronic pancreatitis: challenges and advances in pathogenesis, genetics, diagnosis, and therapy. Gastroenterology. 2007;132:1557–1573
  4. Fasanella KE, Davis B, Lyons J, et al. Pain in chronic pancreatitis and pancreatic cancer. Gastroenterol Clin North Am. 2007;36:335–364
  5. Lieb JG, Forsmark CE. Review article: pain and chronic pancreatitis. Aliment Pharmacol Ther. 2009;29:706–719
  6. Anapurthy R, Pasricha PJ. Pain and chronic pancreatitis. Is it the plumbing or the wiring?. Curr Gastroenterol Rep. 2008;10:101–116
  7. Dimcevski G, Sami SA, Funch-Jensen P, et al. Pain in chronic pancreatitis: the role of reorganization in the central nervous system. Gastroenterology. 2007;132:1546–1556
  8. Drewes AM, Krarup AL, Detlefsen S, et al. Pain in chronic pancreatitis: the role of neuropathic mechanisms. Gut. 2008;57:1616–1627
  9. Gleeson FC, Topazian M. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound for the diagnosis of chronic pancreatitis. Curr Gastroenterol Rep. 2007;9:123–129
  10. Forsmark CE. The early diagnosis of chronic pancreatitis. Clin Gastroenterol Hepatol. 2008;6:1291–1293
  11. Chowdhury RC, Forsmark CE. Pancreatic function testing. Aliment Pharmacol Ther. 2003;15:733–750
  12. Raimondi S, Maisonneuve P, Lowenfels AB. Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol. 2009;6:699–708
  13. Strum WB. Abstinence in alcoholic chronic pancreatitis. Effect on pain and outcome. J Clin Gastroenterol. 1995;20:4–5
  14. Nordback I, Pelli H, Lappalainen-Lehto R, et al. The recurrence of alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology. 2008;136:848–855
  15. Yadav D, Hawes RH, Brand RE, et al., for the North American Pancreatic Study Group  Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009;169:1035–1045
  16. Tolstrup JS, Kristiansen L, Becker U, Gronbaek M. Smoking and the risk of acute and chronic pancreatitis among women and men: a population-based cohort study. Arch Intern Med. 2009;169:603–609
  17. Wilder-Smith CH, Hill L, Osler W, O’Keefe S. Effect of tramadol and morphine on pain and gastrointestinal function in patients with chronic pancreatitis. Dig Dis Sci. 1999;44:1107–1116
  18. Winstead NS, Wilcox CM. Clinical trials of pancreatic enzyme replacement for painful chronic pancreatitis – a review. Pancreatology. 2009;9:344–350
  19. Warshaw AL, Banks PA, Fernandez-Del Castillo C. AGA technical review: treatment of pain in chronic pancreatitis. Gastroenterology. 1998;115:765–776
  20. Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology. 2009;136:149–159
  21. Puli SR, Reddy JB, Bechtold ML, et al. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci. 2009;54:2330–2337
  22. Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–134
  23. Michaels AJ, Draganov PV. Endoscopic ultrasonography guided celiac plexus neurolysis and celiac plexus block in the management of pain due to pancreatic cancer and chronic pancreatitis. World J Gastroenterol. 2007;13:3575–3580
  24. Buscher HC, Schipper EE, Wilder-Smith OH, et al. Limited effect of thoracoscopic splanchnicectomy in the treatment of severe chronic pancreatitis pain: a prospective long-term analysis of 75 cases. Surgery. 2008;143:715–722
  25. Baghdadi S, Abbas MH, Albouz F, Ammori BJ. Systematic review of the role of thoracoscopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2008;22:580–588
  26. Rosch T, Daniel S, Scholz , et al., for the European Society of Gastrointestinal Endoscopy Research  Endoscopic treatment of chronic pancreatitis: a multicenter study of 1000 patients with long-term follow-up. Endoscopy. 2002;34:765–771
  27. Wilcox CM, Varadarajulu S. Endoscopic therapy for chronic pancreatitis: an evidence-based review. Curr Gastroenterol Rep. 2006;8:104–110
  28. Dumoneau JM, Costamagna G, Tringali A, et al. Treatment for painful calcified chronic pancreatitis: extracorporeal shock wave lithotripsy versus endoscopic treatment: a randomised controlled trial. Gut. 2007;56:545–552
  29. Strobel O, Buchler MW, Werner J. Surgical therapy for chronic pancreatitis: indications, techniques, and results. Int J Surg. 2009;7:305–312
  30. Bachmann ST, Busch P, Mann O, et al. Resection vs. drainage in treatment of chronic pancreatitis: long-term results of a randomized trial. Gastroenterology. 2008;134:1605–1607
  31. Buchler MW, Warshaw AL. Resection versus drainage in treatment of chronic pancreatitis. Gastroenterology. 2008;134:1605–1607
  32. Hill JS, McPhee JT, Whalen GF, et al. In-hospital mortality after pancreatic resection for chronic pancreatitis: population-based estimates from the nationwide inpatient sample. J Am Coll Surg. 2009;209:468–476
  33. Dite P, Ruzicka M, Zboril V, Novotny I. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy. 2003;35:553–558
  34. Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med. 2007;356:676–684
  35. Saforkas GH, Farnell MB, Farley DR, et al. Long-term results after surgery for chronic pancreatitis. Int J Pancreatol. 2000;27:131–142
  36. Anderson DK, Frey CF. The evolution of surgical treatment of chronic pancreatitis. Ann Surg. 2010;251:18–32
  37. Yekebas EF, Bogoevski D, Honarpisheh H, et al. Long-term follow-up in small duct chronic pancreatitis: a plea for extended drainage by ‘V-shaped excision’ of the anterior aspect of the pancreas. Ann Surg. 2006;244:940–946
  38. Garcea G, Weaver J, Phillips J, et al. Total pancreatectomy with and without islet cell transplantation for chronic pancreatitis: a series of 85 consecutive patients. Pancreas. 2009;38:1–7
  39. Ahmad SA, Lowry AM, Wray CJ, et al. Factors associated with insulin and narcotic independence after islet autotransplantation in patient with severe chronic pancreatitis. J Am Coll Surg. 2005;201:680–687

PII: S1521-6918(10)00041-7

doi: 10.1016/j.bpg.2010.03.007

Best Practice & Research Clinical Gastroenterology
Volume 24, Issue 3 , Pages 323-335 , June 2010

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