What Is the Place of Interventional Endoscopic Treatment in Chronic Pancreatitis with Inflammatory Tumor of the Pancreatic Head?

Interventional endoscopic treatment in chronic pancreatitis includes the following: (1) management of main pancreatic duct stricture (plastic stents, self-expandable metallic stents, endosonography-guided access); (2) management of pancreatic stones (extracorporeal shock wave lithotripsy [ESWL] combined or not with endoscopic retrograde cholangiopancreatography [ERCP], intraductal lithotripsy); (3) management of pancreatic pseudocyst (transpapillary route, transmural route); (4) management of chronic pancreatitis-related biliary strictures. In this chapter, we address the up-to-date standard concept and therapeutic strategies based on international guidelines, reviews, and selected articles. Though endoscopic treatment is thought to be a first-line choice for management, in daily clinical practice available options, including surgery, should be discussed in a multidisciplinary team. Most important, physicians must reconfirm that endoscopic treatment in chronic pancreatitis is based on the premise that pancreatic malignancies have been excluded.