PubMed · 13671237
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A GRAHAM, I C GILLILAND. 1959-08-22. Riedel's thyroiditis.. https://doi.org/10.1136/bmj.2.5146.225-a
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Chronic pancreatitis has been defined by features that are clinical and etiologic in origin. From such definitions a number of classifications have been developed, starting with the Marseille Classification in 1963. Defining features of chronic pancreatitis must consider the etiology of the disease, which then presents characteristic clinical evidence through symptomatic sequelae of organ pathology, including complications of the disease. Advancing technology has improved the imaging capabilities available to document derangements of the pancreas. The main purpose of international classifications of disease states is to provide a common language for purposes of clinical, research, and health outcomes studies. Modification of the 10th World Health Organization I.C.D. classification may provide this tool.
Chronic pancreatitis is a progressive fibrosis of the pancreas that leads to loss of endocrine and exocrine function. The most common symptom in this disease is intractable pain. The etiology of pain in chronic pancreatitis is not clearly understood. However, many of these patients have dilated ducts consisting of saccular dilations and intervening constructions referred to as the "chain of lakes" phenomenon. These patients can be diagnosed with either endoscopic retrograde cholangiopancreatography (ERCP) or computed tomography (CT). These patients are best treated by the Partington Rochelle modification of the Puestow Procedure otherwise known as lateral pancreaticojejunostomy. Overall pain relief in published studies occurs in 50-90% of patients. Another proposed advantage of the lateral pancreaticojejunostomy is preservation of endocrine and exocrine pancreatic function as long as the pancreas is not further damaged by alcohol.