Evidence-based clinical practice guidelines for chronic pancreatitis 2021

Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal i...

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Veröffentlicht in:Journal of gastroenterology Jg. 57; H. 10; S. 709 - 724
Hauptverfasser: Shimizu, Kyoko, Ito, Tetsuhide, Irisawa, Atsushi, Ohtsuka, Takao, Ohara, Hirotaka, Kanno, Atsushi, Kida, Mitsuhiro, Sakagami, Junichi, Sata, Naohiro, Takeyama, Yoshifumi, Tahara, Junko, Hirota, Morihisa, Fujimori, Nao, Masamune, Atsushi, Mochida, Satoshi, Enomoto, Nobuyuki, Shimosegawa, Tooru, Koike, Kazuhiko
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Singapore Springer Nature Singapore 01.10.2022
Springer
Springer Nature B.V
Schlagworte:
Abdominal Surgery
Clinical medicine
Clinical practice guidelines
Colorectal Surgery
Diagnostic equipment (Medical)
Drug therapy
Endoscopy - adverse effects
Evidence-based medicine
Gastroenterology
Hepatology
Humans
Inflammation
Medicine
Medicine & Public Health
Pain
Pancreas
Pancreas - pathology
Pancreatitis
Pancreatitis, Chronic - diagnosis
Pancreatitis, Chronic - etiology
Pancreatitis, Chronic - therapy
Practice guidelines (Medicine)
Review
Risk Factors
Surgical Oncology
Pathogenic fibro-inflammatory syndrome
Early chronic pancreatitis
Prognosis
Staging
Surgical treatment
Pancreatic enzyme replacement therapy
Pancreatogenic diabetes
Diagnosis
2019 CP clinical diagnostic criteria
Endoscopic treatment
Mechanistic definition
Pancreatic exocrine insufficiency
ISSN:0944-1174, 1435-5922, 1435-5922
Online-Zugang:Volltext
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Zusammenfassung:Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Methods The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. Results Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. Conclusions These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP.
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ISSN:0944-1174
1435-5922
1435-5922
DOI:10.1007/s00535-022-01911-6