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World J Clin Cases. Dec 16, 2023; 11(35): 8263-8269
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8263
Non-pharmacological pain palliation methods in chronic pancreatitis
Mesut Tez, Eda Şahingöz, Hüseyin Fahri Martlı
Mesut Tez, Department of Surgery, University of Health Sciences, Ankara City Hospital, Ankara 06800, Turkey
Eda Şahingöz, Department of General Surgery, Sağlık Bilimleri University, Ankara 06100, Turkey
Hüseyin Fahri Martlı, Department of General Surgery, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara 06100, Turkey
Author contributions: Tez M, Şahingöz E and Martlı HF wrote the first draft of the paper and constructed the flow chart and tables.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mesut Tez, MD, Chief Physician, Department of Surgery, University of Health Sciences, Ankara City Hospital, District of Universities, Bilkent Street No. 1, Ankara 06800, Turkey. mesuttez@yahoo.com
Received: October 14, 2023
Peer-review started: October 14, 2023
First decision: October 29, 2023
Revised: October 30, 2023
Accepted: December 1, 2023
Article in press: December 1, 2023
Published online: December 16, 2023
Processing time: 60 Days and 22.4 Hours
Abstract

Chronic pancreatitis (CP) is a condition characterized by persistent and often severe pain resulting from the inflammatory disease of the pancreas. While pharmacological treatments play a significant role in palliative pain management, some patients require non-pharmacological methods. This review article focuses on non-pharmacological approaches used to alleviate pain in CP. The article examines non-pharmacological palliation options, including surgery, endoscopic approaches, neurostimulation techniques, acupuncture, and other alternative medicine methods. The effectiveness of each method is evaluated, taking into consideration patient compliance and side effects. Additionally, this article emphasizes the importance of personalized pain management in CP and underscores the need for a multidisciplinary approach. It aims to summarize the existing knowledge on the use of non-pharmacological palliation methods to improve the quality of life for patients with CP.

Keywords: Chronic pancreatitis; Pain; Surgery; Endoscopy

Core Tip: The management of chronic pancreatitis (CP) involves careful planning of surgical interventions to prevent pain from becoming chronic and autonomous, potentially leading to opioid dependency. Early surgery, within the first three years of symptom onset, is associated with better outcomes. Surgical procedures aim to address pancreatic and bile duct obstructions and can be drainage or resection-based, depending on the patient's condition. Minimally invasive and endoscopic options are also available. A multidisciplinary approach, including interventions like celiac plexus blocking, percutaneous nerve stimulation, and acupuncture, can be considered, although further research is needed to confirm their effectiveness. Decision-making should involve input from healthcare providers to determine the most suitable treatment for each CP patient. Additionally, for calcified CP with strictures and calculi, extracorporeal shock-wave lithotripsy is a potential option, with the type and timing of endoscopic treatment tailored to the patient's needs.