English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis

A. Hoffmeister; J. Mayerle; C. Beglinger; M. W. Büchler; P. Bufler; K. Dathe; U. R. Fölsch; H. Friess; J. Izbicki; S. Kahl; E. Klar; J. Keller; W. T. Knoefel; P. Layer; M. Loehr; R. Meier; J. F. Riemann; M. Rünzi; R. M. Schmid; A. Schreyer; B. Tribl; J. Werner; H. Witt; J. Mössner; M. M. Lerch; and members of the guideline committee in the appendix

doi:10.1055/s-0041-107379

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2015; 53(12): 1447-1495
DOI: 10.1055/s-0041-107379

Leitlinie

English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis^[1]

Englischsprachige Version der S3-Leitlinie Chronische Pankreatitis

A. Hoffmeister^*

¹Department of Gastroenterology and Rheumatology, University Hospital of Leipzig

,

J. Mayerle^*

²Department of Medicine A, University Medicine of the Ernst Moritz Arndt University, Greifswald

,

C. Beglinger

³Department of Gastroenterology and Hepatology, University Hospital Basel, Switzerland

,

M. W. Büchler

⁴Department of General, Visceral and Transplantation Surgery, University Hospital, Heidelberg, Ruprecht Karls University, Heidelberg

,

P. Bufler

⁵Dr. von Haunersches Children’s Hospital, Ludwig Maximilian University, Munich

,

K. Dathe

⁶German Society of Digestive and Metabolic Diseases (DGVS), Berlin

,

U. R. Fölsch

⁷Department of General Internal Medicine, Christian Albrechts University, Kiel

,

H. Friess

⁸Surgical Clinic and Polyclinic at the Rechts der Isar Hospital, Technical University, Munich

,

J. Izbicki

⁹Department of General, Visceral and Thoracic Surgery at the University Medical Centre Hamburg-Eppendorf

,

S. Kahl

¹⁰Department of Internal Medicine, Specialisation Gastroenterology, Haematology and Oncology, Nephrology German Red Cross (DRK) Hospital Berlin-Köpenick

,

E. Klar

¹¹General Surgery, Thoracic, Vascular and Transplantation Surgery, University of Rostock

,

J. Keller

¹²Department of Medicine, Israelitic Hospital Hamburg

,

W. T. Knoefel

¹³Department of General, Visceral and Paediatric Surgery, University Hospital Dusseldorf of the Heinrich Heine University

,

P. Layer

¹²Department of Medicine, Israelitic Hospital Hamburg

,

M. Loehr

¹⁴Surgical Gastroenterology, Gastrocentrum, Karolinska University Hospital Huddinge

,

R. Meier

¹⁵Department for Gastroenterology, Kanton Hospital Liestal, Medical University Clinic

,

J. F. Riemann

¹⁶Department of Medicine C at the Hospital of the City Ludwigshafen/Rhine gGmbH

,

M. Rünzi

¹⁷Division of Gastroenterology and Metabolic Disease, Clinics of South Essen

,

R. M. Schmid

¹⁸Department of Medicine 2 at the Rechts der Isar Hospital, Technical University Munich

,

A. Schreyer

¹⁹Institute for Radiodiagnostics at the University Hospital of Regensburg

,

B. Tribl

²⁰Internal Medicine IV, Dept. for Gastroenterology and Hepatology, University Hospital Vienna

,

J. Werner

⁴Department of General, Visceral and Transplantation Surgery, University Hospital, Heidelberg, Ruprecht Karls University, Heidelberg

,

H. Witt

²¹Department of Paediatric Medicine, Children’s Hospital Munich Schwabing, Technical University of Munich

,

J. Mössner^**

¹Department of Gastroenterology and Rheumatology, University Hospital of Leipzig

,

M. M. Lerch^**

²Department of Medicine A, University Medicine of the Ernst Moritz Arndt University, Greifswald

,

and members of the guideline committee in the appendix

› Author Affiliations

Abstract

Chronic pancreatitis is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of pancreatic parenchyma by fibrous connective tissue. This fibrotic reorganisation of the pancreas leads to a progressive exocrine and endocrine pancreatic insufficiency. In addition, characteristic complications arise, such as pseudocysts, pancreatic duct obstructions, duodenal obstruction, vascular complications, obstruction of the bile ducts, malnutrition and pain syndrome. Pain presents as the main symptom of patients with chronic pancreatitis. Chronic pancreatitis is a risk factor for pancreatic carcinoma. Chronic pancreatitis significantly reduces the quality of life and the life expectancy of affected patients. These guidelines were researched and compiled by 74 representatives from 11 learned societies and their intention is to serve evidence-based professional training as well as continuing education. On this basis they shall improve the medical care of affected patients in both the inpatient and outpatient sector. Chronic pancreatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy.

Zusammenfassung

Die chronische Pankreatitis ist eine Erkrankung der Bauchspeicheldrüse, bei der rezidivierende Entzündungsschübe zu einem Ersatz des Pankreasparenchyms durch narbiges Bindegewebe führen. Diese Narbenbildung des Pankreas führt zu einem fortschreitenden Verlust der exokrinen und endokrinen Pankreasfunktion. Darüber hinaus treten typische Komplikationen auf zu denen die Bildung von Pseudozysten, Stenosen im Pankreasgang, Obstruktionen des Zwölffingerdarms, Gefäßkomplikationen, einer Obstruktion des Gallengangs, eine Mangel- und Fehlernährung sowie ein Schmerzsyndrom gehören. Das wichtigste Symptom der chronischen Pankreatitis sind abdominelle Schmerzen. Die chronische Pankreatitis stellt einen Risikofaktor für die Entstehung des Pankreaskarzinoms dar. Die chronische Pankreatitis reduziert sowohl die Lebensqualität als auch die Lebenserwartung betroffener Patienten deutlich. Die hier vorgelegte Leitlinie wurde von 74 Vertretern aus 11 Fachgesellschaften als Basis für eine evidenzbasierte Fort- und Weiterbildung zusammengestellt. Ihr Ziel ist es, die medizinische Versorgung betroffener Patienten sowohl im ambulanten als auch im stationären Bereich zu verbessern. Wegen ihrer Krankheitsschwere, ihrer Häufigkeit, ihres chronischen Verlaufs und ihres deutlich negativen Einflusses auf die Lebensqualität und die Lebenserwartung, bedürfen Patienten mit chronischer Pankreatitis einer angemessenen Diagnostik und systematischen Therapie.

Key words

pancreas - chronic pancreatitis - guideline

Schlüsselwörter

pankreas - chronische Pankreatitis - leitlinie

Full Text

References

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English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis[1]

English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis^[1]