Abstract
Chronic pancreatitis (CP) is a progressive inflammatory disease with several complications. Endoscopic methods make essential contributions to diagnosis and treatment. Endoscopic ultrasound is considered the most sensitive method for diagnosing early CP. Symptoms related to CP, failure of medical therapy, pancreatic changes in imaging (obstructive stones, strictures, and main pancreatic duct [MPD] dilatation), and complications (strictures, pseudocyst, and disruption of MPD) require interventional endoscopic methods. Pancreatic duct stenting could be beneficial when the patient has a dominant stricture in the pancreatic head or a refractory MPD stricture. Before stenting, underlying malignancy should be ruled out by brush cytology. In refractory cases, multiple plastic stents or fully covered self-expanding stents are necessary. Extracorporeal shock wave lithotripsy can also be performed with or without endoscopic retrograde cholangiography for stones in the pancreatic duct. In this case, the stone characteristics, stricture, and exocrine function determine the procedure. Endoscopic ultrasound-guided transmural or transpapillary drainage may be performed for pseudocyst-related CP, which has a success rate similar to surgery. Endosonography-guided celiac plexus block can also be used to treat CP.