Current options for the diagnosis of chronic pancreatitis

Abstract

The diagnostic options for chronic pancreatitis have evolved over recent years. The previous gold standard references for structural imaging and exocrine pancreatic function testing have both been supplanted and redesigned. Endoscopic retrograde pancreatography has now been overtaken by endoscopic ultrasound and magnetic resonance cholangiopancreatography, whilst the old technique for Dreiling tube pancreatic function testing has now been replaced by the endoscopic pancreatic function test. New advances in endoscopic ultrasound elastography have also extended the options for evaluating pancreatic masses to differentiate mass-forming chronic pancreatitis from malignancy. Genetic contribution to chronic pancreatitis is also now more widely recognized than ever before.

Keywords::

• chronic pancreatitis
• diagnosis
• elastography
• endoscopic ultrasound
• genetics
• imaging
• magnetic resonance cholangiopancreatography
• pancreatic function tests

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

The key issues in the diagnosis of chronic pancreatitis (CP) include:

• Differentiating CP from other conditions, which may present with similar symptoms and signs, such as irritable bowel syndrome, inflammatory bowel disease and pancreatic malignancy.

• Understanding the central role of pancreatic structural imaging in the diagnosis of CP.

• Recognizing that impairment of pancreatic exocrine function may result from conditions other than CP.

Notes