[Surgery or invasive endoscopy for the treatment of chronic pancreatitis?].

Chronic pancreatitis is primarily an internal medical disease. However, conservative therapy does not always solve the symptoms, and in such cases some kind of intervention is needed. The related possibilities are examined in the present study. Surgical indications are intractable pain, pseudocyst formation, compression syndrome and the suspicion of malignancy. Invasive endoscopy is also involved in the management of chronic pancreatitis, that could be the first-line therapy in selected cases, namely in the case of pseudocyst, among poor-risk patients for the treatment of stenosis of biliary and pancreatic duct and also in the case of partial rupture of the Wirsung-duct. Further trials are needed to elucidate the problems. It can be concluded that both surgical and endoscopic therapy have place in the armamentarium of the treatment of chronic pancreatitis, based on suitable criteria.