Chronic Pancreatitis Management

Chronic pancreatitis involves progressive inflammatory destruction of pancreatic parenchyma with replacement by fibrotic tissue, leading to irreversible loss of exocrine (digestive enzymes) and endocrine (insulin, glucagon) function. Alcohol is the most common cause (60–70%), followed by genetic mutations (PRSS1, CFTR, SPINK1), autoimmune pancreatitis, and idiopathic causes. The sentinel acute pancreatitis event (SAPE) hypothesis proposes that an initial acute episode activates pancreatic stellate cells, which produce collagen and drive fibrosis through repeated injury-repair cycles. Progressive fibrosis causes ductal obstruction, calcification, and nerve damage producing chronic severe pain.