{"title":"慢性胰腺炎和胰腺外分泌功能不全","authors":"Søren Schou Olesen","doi":"10.1016/j.mpmed.2024.02.004","DOIUrl":null,"url":null,"abstract":"<div><p>Chronic pancreatitis is a fibro-inflammatory disease of the pancreas characterized by inflammation and fibrosis. It is associated with excessive alcohol consumption and smoking, although a number of other risk factors are increasingly recognized, including a genetic predisposition. Patients typically present with upper abdominal pain, weight loss and changes in bowel habits caused by exocrine pancreatic insufficiency. Additionally, chronic pancreatitis is frequently complicated by post-pancreatitis diabetes mellitus and a number of other conditions, including common bile duct stenosis and duodenal obstruction. Because of malabsorption, patients also have an increased risk of osteoporosis and low-energy fractures. Alcohol abstinence and smoking cessation are key elements of management. Pain is often the most prominent symptom and has a multifactorial aetiology that requires a multidisciplinary treatment approach, including specialized endoscopic and surgical expertise. Exocrine pancreatic insufficiency is treated by enzyme replacement therapy with careful monitoring of patients’ macro- and micronutritional state, including a systematic assessment of bone health. Post-pancreatitis diabetes mellitus requires special therapeutic considerations because of a high risk of hypoglycaemia. Most patients obtain acceptable quality of life when adhering to modern treatment recommendations.</p></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic pancreatitis and exocrine pancreatic insufficiency\",\"authors\":\"Søren Schou Olesen\",\"doi\":\"10.1016/j.mpmed.2024.02.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Chronic pancreatitis is a fibro-inflammatory disease of the pancreas characterized by inflammation and fibrosis. It is associated with excessive alcohol consumption and smoking, although a number of other risk factors are increasingly recognized, including a genetic predisposition. Patients typically present with upper abdominal pain, weight loss and changes in bowel habits caused by exocrine pancreatic insufficiency. Additionally, chronic pancreatitis is frequently complicated by post-pancreatitis diabetes mellitus and a number of other conditions, including common bile duct stenosis and duodenal obstruction. Because of malabsorption, patients also have an increased risk of osteoporosis and low-energy fractures. Alcohol abstinence and smoking cessation are key elements of management. Pain is often the most prominent symptom and has a multifactorial aetiology that requires a multidisciplinary treatment approach, including specialized endoscopic and surgical expertise. Exocrine pancreatic insufficiency is treated by enzyme replacement therapy with careful monitoring of patients’ macro- and micronutritional state, including a systematic assessment of bone health. Post-pancreatitis diabetes mellitus requires special therapeutic considerations because of a high risk of hypoglycaemia. Most patients obtain acceptable quality of life when adhering to modern treatment recommendations.</p></div>\",\"PeriodicalId\":74157,\"journal\":{\"name\":\"Medicine (Abingdon, England : UK ed.)\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicine (Abingdon, England : UK ed.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1357303924000409\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicine (Abingdon, England : UK ed.)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1357303924000409","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Chronic pancreatitis and exocrine pancreatic insufficiency
Chronic pancreatitis is a fibro-inflammatory disease of the pancreas characterized by inflammation and fibrosis. It is associated with excessive alcohol consumption and smoking, although a number of other risk factors are increasingly recognized, including a genetic predisposition. Patients typically present with upper abdominal pain, weight loss and changes in bowel habits caused by exocrine pancreatic insufficiency. Additionally, chronic pancreatitis is frequently complicated by post-pancreatitis diabetes mellitus and a number of other conditions, including common bile duct stenosis and duodenal obstruction. Because of malabsorption, patients also have an increased risk of osteoporosis and low-energy fractures. Alcohol abstinence and smoking cessation are key elements of management. Pain is often the most prominent symptom and has a multifactorial aetiology that requires a multidisciplinary treatment approach, including specialized endoscopic and surgical expertise. Exocrine pancreatic insufficiency is treated by enzyme replacement therapy with careful monitoring of patients’ macro- and micronutritional state, including a systematic assessment of bone health. Post-pancreatitis diabetes mellitus requires special therapeutic considerations because of a high risk of hypoglycaemia. Most patients obtain acceptable quality of life when adhering to modern treatment recommendations.