Patients with Chronic Pancreatitis: Management Strategy using 2013 RGA* Draft Guidelines
Study Objective: To put the key points of the Russian Gastroenterological Assodation Draft Guidelines for Chromc Pancreatitis (CP) into clinical practice. Key Points: According to current approaches to diagnosing and treating CP, this condition сап be diagnosed only by accurate non-invasive methods of morphology assessment. These include multi-slice helical computed tomography and/or endoscopic ultrasound. Significant pain associated with CP requires the administration of analgesics, pancreatin preparations, and, possibly, tricyclic antidepressants and combination supplements, including vitamin and mineral substances with antioxidant properties. For patients with exocrine pancreatic insufficiency, treatment must include enzyme substitution therapy using modern pancreatin preparations (such as Creon) at doses of > 25,000-40,000 units of lipase for main meal and 10,000-25,000 units of lipase for snacks. The authors describe decision and management algorithms for verified and possible/probable CP. Conclusion: Guidelines help practitioners in their work. As part of a standardized approach, they help to achieve positive outcomes in approximately 80% of cases.