By Prof. Dr. med. P. G. Lankisch, Prof. Dr. med. M. Büchler, Prof. Dr. med. J. Mössner, Prof. Dr. S. Müller-Lissner (auth.)
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Additional resources for A Primer of Pancreatitis
In cases with difficult access percutaneous drainage is preferred. Pancreatic stones The extraction of pancreatic duct stones may improve pain and probably slow the progressive loss of pancreatic function. Larger stones may require fragmentation by shock wave lithotripsy prior to extraction with a basket. Pancreatic duct stricture A stricture may speed loss of secretory function and cause pain. If located in the pancratic head stenting for some months may prove beneficial.
It seems to be on the increase. The prevalence is between 25 and 30 per 100,000 adult inhabitants. Course The course of the pain cannot be predicted. Abstinence from alcohol may alleviate the pain. A decrease in pain and the course of exocrine and endocrine insufficiency do not run in parallel. Social consequences Within 10 years 25 % of the patients retire, in half of these cases retirement is due to pancreatitis. Prognosis Very few patients die from chronic pancreatitis itself. The main causes of death are cardiovascular diseases and malignant tumours.
To ensure simultaneous emptying of the enzymes with the chyme, preparations with smaller particle sizes should be preferred. Enzyme preparations containing bile acids should be avoided since, at the high doses often required with enzyme preparations, bile acids can lead to chologenic diarrhoea. Ph. units per dayl. Depending on the preparation in question, this corresponds to 2-4 capsules with each main meal and 1-2 capsules with each snack. g. other causes of steatorrhoea). e. before or after instead of with the meals) or underdosage may be responsible.
A Primer of Pancreatitis by Prof. Dr. med. P. G. Lankisch, Prof. Dr. med. M. Büchler, Prof. Dr. med. J. Mössner, Prof. Dr. S. Müller-Lissner (auth.)