Current advances in the management of chronic pancreatitis

Chronic pancreatitis is characterized by irreversible destruc-tion of pancreatic parenchyma and its ductal system result-ing from longstanding inflammation, leading to fibrosis and scarring due to genetic, environmental, and other risk fac-tors. The diagnosis of chronic pancreatitis is made based on a combination of clinical features and characteristic findings on computed tomography or magnetic resonance imaging. Ab-dominal pain is the most common symptom of chronic pan-creatitis. The main aim of treatment is to relieve symptoms, prevent disease progression, and manage complications re-lated to chronic pancreatitis. Patients who do not respond to medical treatment or not a candidate for surgical treat-ment are usually managed with endoscopic therapies. En-doscopic therapies help with symptoms such as abdominal pain and jaundice by decompression of pancreatic and biliary ducts. This review summarizes the risk factors, pathophysiol-ogy, diagnostic evaluation, endoscopic treatment of chronic pancreatitis, and complications. We have also reviewed re-cent advances in endoscopic retrograde cholangiopancreatog- raphy and endoscopic ultrasound-guided therapies for pancreatic duct obstruction due to stones, strictures, pancreatic divisum, and biliary strictures. (c) 2021 Elsevier Inc. All rights reserved.