Multidisciplinaire behandeling van chronische pancreatitis

• Chronic pancreatitis is a progressive inflammatory disease, which leads to a severe decrease in quality of life and reduced life expectancy.
• 85-90% of patients with chronic pancreatitis consult the doctor because of pain.
• Pain in chronic pancreatitis has a multifactorial aetiology, with nociceptive and neuropathological components.
• Current treatment of chronic pancreatitis uses a step-up approach, starting with lifestyle interventions and medication, followed by endoscopic or surgical treatment or a combination of these two.
• Surgical drainage or resection is more effective than repeated endoscopic treatment for patients with advanced chronic pancreatitis who use opiates.
• There are indications that early surgical intervention in painful chronic pancreatitis and a dilated pancreatic duct provides better results than the current step-up approach; this is currently being investigated in the ESCAPE trial.

Conflict of interest and financial support: M.A. Boermeester has received an unrestricted grant from Mylan for the Chronic Pancreatitis Registry. ICMJE forms provided by the authors are available online along with the full text of this article.