What are The Treatment Options for Pancreatitis? - Q&a

[MUSIC] I am Vikesh Singh, I am a gastroenterologist at Johns Hopkins. I am the director of the Pancreatitis Center. And I am the Medical Director of the Islet Auto-Transplantation program. I specialize in inflammatory dis, disorders of the pancreas, as well as interventional endoscopy. [MUSIC] There are many options for the treatment of chronic pancreatitis. These include medical, endoscopic, and surgical options. All patients are offered medical options for treatment. These treatments focus on the pain of chronic pancreatitis. These typically include adherence to a low fat diet, avoidance of alcohol and tobacco, the use of pancreatic enzyme supplements, as well as pain medication. Unfortunately, most patients will not respond to medical treatments for chronic pancreatitis. The other options include endoscopic and surgical treatment of chronic pancreatitis. Endoscopic therapy is most commonly offered to those patients who have a dilated pancreatic duct. These patients can undergo an endoscopic procedure known as an endoscopic retrograde cholangiopancreatography, and the goal of this procedure is to dilate strictures, to remove pancreatic duct stones and to place pancreatic ducts stents. [MUSIC] For those patients with small duct disease they can be offered procedures such as the Whipple, and total pancreatectomy. And for patients with large duct disease, they can be offered procedures such as the Frey and Puestow. [MUSIC] At Johns Hopkins, we have a team-based approach to evaluating and managing patients with chronic pancreatitis. We are constantly looking for new medical, endoscopic and surgical therapies for treating the very difficult patients. There have been some developments in the field of endoscopic ultrasound with celiac plexus blockade. This procedure can be used to help alleviate the pain associated with chronic pancreatitis. At least in the short term as more long term options are pursued. The the greatest option that has emerged over the years for the surgical treatment of chronic pancreatitis is total pancreatectomy with or without islet cell auto-transplantation. [MUSIC] The selection of the optimal candidate with chronic pancreatitis for a total pancreatectomy with or without islet cell auto-transplantation is a complex and difficult process. This typically involves the coordinated evaluation of the patient by a team of specialists including a gastroenterologist, a surgeon, a pain management specialist, and an endocrinologist. [MUSIC] Johns Hopkins offers a team-based approach to the care of patients with chronic pancreatitis. We have a group of dedicated subspecialists who evaluate each and every patient. And then we meet to discuss how we may best offer individualized therapy. [MUSIC]