The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate
The most controversial provisions of the Russian Consensus on Diagnosis and Treatment of Chronic Pancreatitis (hereinafter, the Consensus) are presented. The debate has been initiated by the Russian Pancreatic Club and performed with the use of the Delphi system, based on interdisciplinary approach...
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2016-09-01
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doaj-e253ffa0e84c46a6b1fd10b8271d8d312021-07-28T21:11:21ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942016-09-0144665466010.18786/2072-0505-2016-44-6-654-660363The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debateI. E. Khat'kov0I. V. Maev1D. S. Bordin2Yu. A. Kucheryavyy3V. B. Grinevich4Moscow Clinical Scientific and Practical Center, Moscow Healthcare Department, Moscow; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, MoscowMoscow State University of Medicine and Dentistry named after A.I. Evdokimov, MoscowMoscow Clinical Scientific and Practical Center, Moscow Healthcare Department, MoscowMoscow State University of Medicine and Dentistry named after A.I. Evdokimov, MoscowKirov Military Medical Academy, Saint PetersburgThe most controversial provisions of the Russian Consensus on Diagnosis and Treatment of Chronic Pancreatitis (hereinafter, the Consensus) are presented. The debate has been initiated by the Russian Pancreatic Club and performed with the use of the Delphi system, based on interdisciplinary approach with participation of leading gastroenterologists, surgeons and pediatricians. This paper is the first in the series of the Consensus-related publications. Here we discuss the most controversial issues of Chapter 5 "Treatment of acute episodes" and Chapter 8 "Strategies of pain syndrome management". While discussing the conventional recommendation of a period of starvation for patients with clinical symptom of exacerbation of chronic pancreatitis, it was noted that for a long time it had been virtually the only way to provide functional rest for the pancreas. However, patients with chronic pancreatitis are frequently in malnutrition, therefore, starving may aggravate nutritional deficit that significantly affects the prognosis; therefore, early nutritional support is indicated. To alleviate functional strain of the pancreas, it is reasonable to use enteral nutrition elemental and semi-elemental formulas. The transition from formulas to conventional nutrition should be accompanied by administration of adequate pancreatin doses. The role of pancreatic enzymes, spasmolytics and proton pump inhibitors in the management of pain syndrome was also controversial.https://www.almclinmed.ru/jour/article/view/372chronic pancreatitisinterdisciplinary consensusdelphi systempancreatic club |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
I. E. Khat'kov I. V. Maev D. S. Bordin Yu. A. Kucheryavyy V. B. Grinevich |
spellingShingle |
I. E. Khat'kov I. V. Maev D. S. Bordin Yu. A. Kucheryavyy V. B. Grinevich The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate Alʹmanah Kliničeskoj Mediciny chronic pancreatitis interdisciplinary consensus delphi system pancreatic club |
author_facet |
I. E. Khat'kov I. V. Maev D. S. Bordin Yu. A. Kucheryavyy V. B. Grinevich |
author_sort |
I. E. Khat'kov |
title |
The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
title_short |
The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
title_full |
The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
title_fullStr |
The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
title_full_unstemmed |
The Russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
title_sort |
russian consensus on diagnosis and treatment of chronic pancreatitis: points of debate |
publisher |
MONIKI |
series |
Alʹmanah Kliničeskoj Mediciny |
issn |
2072-0505 2587-9294 |
publishDate |
2016-09-01 |
description |
The most controversial provisions of the Russian Consensus on Diagnosis and Treatment of Chronic Pancreatitis (hereinafter, the Consensus) are presented. The debate has been initiated by the Russian Pancreatic Club and performed with the use of the Delphi system, based on interdisciplinary approach with participation of leading gastroenterologists, surgeons and pediatricians. This paper is the first in the series of the Consensus-related publications. Here we discuss the most controversial issues of Chapter 5 "Treatment of acute episodes" and Chapter 8 "Strategies of pain syndrome management". While discussing the conventional recommendation of a period of starvation for patients with clinical symptom of exacerbation of chronic pancreatitis, it was noted that for a long time it had been virtually the only way to provide functional rest for the pancreas. However, patients with chronic pancreatitis are frequently in malnutrition, therefore, starving may aggravate nutritional deficit that significantly affects the prognosis; therefore, early nutritional support is indicated. To alleviate functional strain of the pancreas, it is reasonable to use enteral nutrition elemental and semi-elemental formulas. The transition from formulas to conventional nutrition should be accompanied by administration of adequate pancreatin doses. The role of pancreatic enzymes, spasmolytics and proton pump inhibitors in the management of pain syndrome was also controversial. |
topic |
chronic pancreatitis interdisciplinary consensus delphi system pancreatic club |
url |
https://www.almclinmed.ru/jour/article/view/372 |
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