Chronic pancreatitis
1. Big picture
Chronic pancreatitis is a progressive fibro-inflammatory destruction of the pancreas. Unlike acute pancreatitis, which is an emergency inflammatory episode, chronic pancreatitis is a long-term structural disease causing:
- Chronic abdominal pain
- Pancreatic duct strictures/stones
- Exocrine pancreatic insufficiency → steatorrhea, weight loss
- Endocrine insufficiency → diabetes mellitus
- Local complications → pseudocyst, biliary obstruction, duodenal obstruction, splenic vein thrombosis
- Increased pancreatic cancer risk
The surgical exam question is mainly:
Chronic pancreatitis
↓
Is there pain, duct dilatation, inflammatory head mass, pseudocyst, obstruction, or cancer suspicion?
↓
Choose medical, endoscopic, drainage, resection, or combined surgery
Key oral-exam sentence:
Surgery in chronic pancreatitis is not for inflammation itself; it is for pain, obstruction, complications, or suspicion of malignancy.
2. Definition
Chronic pancreatitis is a chronic irreversible inflammatory disease of the pancreas characterized by progressive fibrosis, ductal distortion, calcification, loss of acinar tissue, and later endocrine destruction.
Result:
Repeated injury → fibrosis + duct obstruction + calcification
↓
Pain + maldigestion + diabetes + local complications
3. Surgical anatomy you must know
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