In the past year, there has been at least one important clinical paper that sheds light on the character and natural history of painful
chronic pancreatitis, which has important clinical implications. In addition, several novel mutations have been described in the cationic
trypsinogen gene in patients with
hereditary pancreatitis. The mechanism by which these mutations cause
pancreatic disease remains speculative. The diagnosis of early
chronic pancreatitis is controversial. A novel noninvasive pancreatic function test (measurement of postprandial
APOB-48) was reported but is unlikely to be a sensitive test of pancreatic function. Pancreatic
fibrosis is frequently seen in alcoholics without
chronic pancreatitis, and this makes it difficult to interpret the findings on endoscopic ultrasonogram. Recent studies highlight the difficulty in abolishing pancreatic
steatorrhea. Recently fibrosing colonopathy in adult patients has been reported.
Extracorporeal shockwave lithotripsy combined with endoscopic
therapy failed to benefit patients with calcific
chronic pancreatitis.