CONTRIBUTION OF ENDOSCOPY IN THE TREATMEN T OF CHRONIC-PANCREATITIS

Endoscopic treatment in patients with chronic pancreatitis involves se veral features : sphincterotomy of the wirsung, dilatation, insertion of a prosthesis, cystoenterostomy, cystowirsungostomy. Extracorporal l ithotrity is often associated Endoscopic treatment appears to give sat isfactory short-term results in cases with pain, pseudocyst or pancrea tic fistula. Morbidity is low. The optimum duration of endoscopic drai nage via the prosthesis is still a question of debate and the long-ter m efficacy remains to be demonstrated. Endoscopic treatment is indicat ed in patients with a definitive or temporary surgical risk or may be indicated for all symptomatic patients. In this case, endoscopic treat ment would be used as a therapeutic test. Stenosis of the main bile du ct is not at present a good indication for endoscopic treatment as thi s stenosis is resistant to balloon dilatation and prosthesis calibrati on.