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Chronic Pancreatitis: Landmark Papers, Management Decisions, and Future

DiMagno, Eugene P. MD; DiMagno, Matthew J. MD

doi: 10.1097/MPA.0000000000000599

On May 16, 2015 at the invitation of the American Gastroenterological Association Institute Council E.P.D. presented a state-of-the-art lecture at Digestive Disease Week 2015. The aims were to discuss a selection of landmark papers in chronic pancreatitis (CP) that influence modern management and to conclude by suggesting some future directions. This is based on that presentation. We will specifically review the following: duct anatomy and pancreas divisum, description of chronic relapsing pancreatitis and its differentiation from recurrent acute pancreatitis and established CP (ECP), natural histories and gene discoveries of alcoholic, idiopathic and hereditary pancreatitis, development of pancreatic cancer in CP, exocrine pancreatic insufficiency and calculation of dose and delivery of enzymes, endoscopic ultrasonography, and autoimmune pancreatitis. With some exceptions, we exclude basic science and surgery.

From the *Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Medical School, Mayo Clinic, Rochester, MN; and †Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI.

Received for publication September 17, 2015; accepted December 1, 2015.

Reprints: Eugene P. DiMagno, MD, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Medical School, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (e-mail:

M.J.D. received the following research support in the past 3 years: NIH/NIAAA (R21AA017271); Michigan Translational Research and Commercialization for Life Sciences Program; and the Cystic Fibrosis Foundation: Developing Innovative Gastroenterology Specialty Training or DIGEST Program.

M.J.D. received honoraria from the British Medical Journal Publishing Group Limited (for articles published in British Medical Journal Point-of-Care), The American Gastroenterological Association (for contributing to a web-based Patient Brochure – Pancreatitis) and Oakstone Publishing (for Podcasts on Pancreatic Disorders, Best of Digestive Disease Week 2013–2015). M.J.D. also received a consulting fee from the American College of Physicians (Philadelphia, Pa) for coauthoring 2 chapters in the gastroenterology and hepatology section of MKSAP 17, entitled “Diseases of the Pancreas” and “Gastrointestinal Bleeding.”

The authors declare no conflict of interest.

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