Pankreatitt, kronisk
Sist oppdatert: Sist revidert:
Sist revidert av:Terje Johannessen
Definisjon:
Kronisk betennelse, i starten som gjentatte episoder med akutt pankreatitt, som fører til permanent ødeleggelse av pankreas
Forekomst:
Insidens varierer mellom 1,6 til 23 tilfeller per 100.000 per år. Prevalens fra 0,04% til 5%
Symptomer:
Kroniske eller episodiske magesmerter, malabsorpsjon, litt sjeldnere steatoré og diabetes
Funn:
Tegn til underernæring ved eksokrin svikt, ev. tegn til alkoholmisbruk, ev. abdominal ømhet
Diagnostikk:
Prøver viser redusert pankreas-isoamylase, trypsin eller lipase i serum. Typiske funn ved røntgen, ultralyd eller ERCP
Behandling:
Omfatter både medisinske, endoskopiske og kirurgiske tiltak
- Engjom T, Hoem D, Kvamme JM, et al. Norsk veileder for diagnostikk og behandling av kronisk pankreatitt. Gastroenterologen, 02.01.2017. http://Gastroenterologen.no/2017/01/norsk-veileder-for-diagnostikk-og-behandling-av-kronisk-pankreatitt
- Nair RJ, Lawler L. Chronic pancreatitis. Am Fam Physician 2007; 76: 1679-88. PubMed
- Ahmad SA, Wray C, Rilo HL, Choe KA, Gelrud A, Howington JA, et al. Chronic pancreatitis: recent advances and ongoing challenges. Curr Probl Surg 2006; 43: 127-238. PubMed
- Mitchell RMS, Byrne MF, Baillie J. Pancreatitis. Lancet 2003; 361: 1447-55. PubMed
- Dufour MC, Adamson MD. The epidemiology of alcohol-induced pancreatitis. Pancreas 2003; 27: 286-290. PubMed
- DiMagno MJ, Wamsteker E-J, Lee A. Chronic pancreatitis. BMJ Best Practice, last updated October 2018.
- Lin Y, Tamakoshi A, Matsuno S, Takeda K, Hayakawa T, Kitagawa M, et al. Nationwide epidemiological survey of chronic pancreatitis in Japan. J Gastroenterol 2000; 35: 136-41. PubMed
- Chen WX, Zhang WF, Li B, Lin HJ, Zhang X, Chen HT, et al. Clinical manifestations of patients with chronic pancreatitis. Hepatobiliary Pancreat Dis Int 2006; 5: 133-7. PubMed
- Finkelberg DL, Sahani D, Deshpande V, Brugge WR. Autoimmune pancreatitis. N Engl J Med 2006; 355: 2670-6. New England Journal of Medicine
- Keiles S, Kammesheidt A. Identification of CFTR, PRSS1, and SPINK1 mutations in 381 patients with pancreatitis. Pancreas 2006; 33: 221-7. PubMed
- Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001; 120: 682-707. Gastroenterology
- Schneider A, Whitcomb DC. Hereditary pancreatitis: a model for inflammatory diseases of the pancreas. Best Pract Res Clin Gastroenterol 2002; 16: 347-63. PubMed
- Stevens T, Conwell DL, Zuccaro G. Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments. Am J Gastroenterol 2004; 99: 2256-70. PubMed
- Conwell DL, Lee LS, Yadav D, et al. American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines. Pancreas. 2014 Nov;43(8):1143-62. doi: 10.1097/MPA.0000000000000237. DOI
- Kempeneers MA, Issa Y, Verdonk RC, et al . Pain patterns in chronic pancreatitis: A nationwide longitudinal cohort study. Gut 2021. pmid:33158979 PubMed
- Malka D, Hammel P, Sauvanet A, Rufat P, O'Toole D, Bardet P, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology 2000; 119: 1324-32. Gastroenterology
- Munoz A, Katerndahl DA. Diagnosis and management of acute pancreatitis. Am Fam Physician 2000; 62: 164-74. American Family Physician
- Engjom T, Hoem D, Kvamme JM, et al. Norsk veileder for diagnostikk og behandling av kronisk pankreatitt. Gastroenterologen, 02.01.2017. gastroenterologen.no
- Remer EM, Baker ME. Imaging of chronic pancreatitis. Radiol Clin North Am 2002; 40: 1229-42. PubMed
- Adler DG, Baron TH, Davila RE, Egan J, Hirota WK, Leighton JA, et al., for the Standards of Practice Committee of American Society for Gastrointestinal Endoscopy. ASGE guideline: the role of ERCP in diseases of the biliary tract and the pancreas. Gastrointest Endosc 2005; 62: 1-8. PubMed
- Makary MA, Duncan MD, Harmon JW, Freeswick PD, Bender JS, Bohlman M, et al. The role of magnetic resonance cholangiography in the management of patients with gallstone pancreatitis. Ann Surg 2005; 241: 119-24. PubMed
- Hollerbach S, Klamann A, Topalidis T, Schmiegel WH. Endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA) cytology for diagnosis of chronic pancreatitis. Endoscopy 2001; 33: 824-31. PubMed
- Olesen SS, Bouwense SA, Wilder-Smith OH, et al. Pregabalin reduces pain in patients with chronic pancreatitis in a randomized, controlled trial. Gastroenterology 2011; 141: 536-43. Gastroenterology
- Hvass Hansen ML, Rumessen JJ. Virker enzymsubstitutionsbehandling analgetisk ved kronisk pancreatitis?. Ugeskr Læger 2005; 167: 1841-4. PubMed
- Czako L, Takacs T, Hegyi P, Pronai L, Tulassay Z, Lakner L, et al. Quality of life assessment after pancreatic enzyme replacement therapy in chronic pancreatitis. Can J Gastroenterol 2003; 17: 597-603. PubMed
- Dominguez-Munoz JE, Iglesias-Garcia J, Iglesias-Rey M, Figueiras A, Vilarino-Insua M. Effect of the administration schedule on the therapeutic efficacy of oral pancreatic enzyme supplements in patients with exocrine pancreatic insufficiency: a randomized, three-way crossover study. Aliment Pharmacol Ther 2005; 21: 993-1000. PubMed
- Haaber AB, Rosenfalck AM, Hansen B, Hilsted J, Larsen S. Bone mineral metabolism, bone mineral density, and body composition in patients with chronic pancreatitis and pancreatic exocrine insufficiency. Int J Pancreatol 2000; 27: 21-7. PubMed
- Jacobson BC, Baron TH, Adler DG, Davila RE, Egan J, Hirota WK, et al., for the American Society for Gastrointestinal Endoscopy. ASGE guideline: the role of endoscopy in the diagnosis and the management of cystic lesions and inflammatory fluid collections of the pancreas. Gastrointest Endosc 2005; 61: 363-70. PubMed
- Rosch T, Daniel S, Scholz M, Huibregtse K, Smits M, Schneider T, et al., for the European Society of Gastrointestinal Endoscopy Research Group. Endoscopic treatment of chronic pancreatitis: a multicenter study of 1000 patients with long-term follow-up. Endoscopy 2002; 34: 765-71. PubMed
- Sharma SS, Bhargawa N, Govil A. Endoscopic management of pancreatic pseudocyst: a long-term follow-up. Endoscopy 2002; 34: 203-7. PubMed
- Guda NM, Partington S, Freeman ML. Extracorporeal shock wave lithotripsy in the management of chronic calcific pancreatitis: a meta-analysis. JOP 2005; 6: 6-12. PubMed
- Dumonceau JM, Costamagna G, Tringali A, Vahedi K, Delhaye M, Hittelet A, et al. Treatment for painful calcified chronic pancreatitis: extracorporeal shock wave lithotripsy versus endoscopic treatment: a randomised controlled trial. Gut 2007; 56: 545-52. Gut
- Kalady MF, Broome AH, Meyers WC, Pappas TN. Immediate and long-term outcomes after lateral pancreaticojejunostomy for chronic pancreatitis. Am Surg 2001; 67: 478-83. PubMed
- Nealon WH, Matin S. Analysis of surgical success in preventing recurrent acute exacerbations in chronic pancreatitis. Ann Surg 2001; 233: 793-800. PubMed
- Jimenez RE, Fernandez-del Castillo C, Rattner DW, Chang Y, Warshaw AL. Outcome of pancreaticoduodenectomy with pylorus preservation or with antrectomy in the treatment of chronic pancreatitis. Ann Surg 2000; 231: 293-300. PubMed
- Keck T, Adam U, Makowiec F, et al. Short- and longterm results of duodenum preservation versus resection for the management of chronic pancreatitis: A prospective, randomized study. Surgery 2012;152: S95 Surgery
- Raimondi S, Lowenfels AB, Morselli-Labate AM, Maisonneuve P, Pezzilli R. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol 2010; 24(3):349-58.
- Terje Johannessen, professor i allmennmedisin, Trondheim
Tidligere fagmedarbeidere
- Henrik Forssell, docent och överläkare, Kirurgkliniken, Blekingesjukhuset, Karlskrona (Medibas)
- Hermod Petersen, professor og overlege, Norges teknisk-naturvitenskapelige universitet og Medisinsk avdeling, Regionsykehuset i Trondheim