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Updates in Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.
Gastroenterol Clin North Am
March 2025
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, California, USA. Electronic address:
Although endoscopic retrograde cholangiopancreatography (ERCP) has been shown to be a safe and effective approach in treating these diseases while carrying lower morbidity than traditional surgical treatments, ERCP has associated risks, with post-ERCP pancreatitis (PEP) being the most common serious adverse event and carries significant morbidity and health care cost. PEP results from multifactorial factors involving trauma to the pancreatic duct and papilla, leading to subsequent obstruction and impairment of pancreatic drainage. Important risk factors for PEP include history of prior PEP, suspected sphincter of Oddi dysfunction, difficult cannulation, pancreatic duct contrast injections, and pancreatic sphincterotomy.
View Article and Find Full Text PDFWhat Is the Latest in Autoimmune Pancreatitis.
Gastroenterol Clin North Am
March 2025
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Electronic address:
Autoimmune pancreatitis (AIP) is a steroid-responsive fibroinflammatory disorder with 2 clinically distinct subtypes known as type 1 autoimmune and type 2 autoimmune pancreatitis. Type 1 AIP is considered the pancreatic manifestation of immunoglobulin G4-related disease, a systemic disease often presenting with other organ involvement. Advances in understanding the unique clinical presentation, imaging findings, histopathology, and clinical course of this relatively uncommon disease have led to international consensus regarding diagnosis and treatment.
View Article and Find Full Text PDFPancreatic Cancer: Screening and Early Detection.
Gastroenterol Clin North Am
March 2025
Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, ST, Suite 7705, Los Angeles, CA 90048, USA. Electronic address:
Pancreatic cancer, often diagnosed at advanced stages, has poor survival rates. Effective screening aims to detect the disease early, improving outcomes. Current guidelines recommend screening high-risk groups, including those with a family history or genetic predispositions, using methods like endoscopic ultrasound and MRI.
View Article and Find Full Text PDFUpdates in the Diagnosis of Chronic Pancreatitis: Current Approaches and New Possibilities.
Gastroenterol Clin North Am
March 2025
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA. Electronic address:
This review provides a comprehensive update on the diagnostic approaches to chronic pancreatitis (CP), emphasizing recent advancements in imaging techniques, biomarker research, and multivariable scoring systems. Despite substantial progress in these areas, current diagnostic algorithms have limitations, particularly for early and non-calcific CP. Traditional criteria have focused on classic diagnostic signs, but "minimal change" CP is increasingly recognized through advanced imaging and function tests.
View Article and Find Full Text PDFPathophysiology, Assessment, and Management of Pain Associated with Chronic Pancreatitis.
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases & Mech-Sense, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Chronic pancreatitis (CP) is a fibroinflammatory disease, with pain as its most prominent symptom. This article provides a comprehensive review of the pathophysiology, assessment methodologies, and management strategies pertaining to pain in CP. Pathophysiological mechanisms include inflammatory and neuropathic components, including peripheral and central sensitization.
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