Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector6153210.17816/KMJ2021-528ReviewsОбзорыReview ArticleDiagnostic value of research methods in diagnostics of chronic pancreatitisДиагностическая ценность методов исследования при диагностике хронического панкреатитаAliyevaG RАлиеваГюнай Рифат кызы
Azerbaijan
gunayaliyeva80@gmail.comScientific Center of Surgery named after M.A. TopchubashovНаучный центр хирургии им. М.А. Топчибашева0808202110245285362202202129062021Copyright ©; 2021, Aliyeva G.R.Copyright ©; 2021, Алиева Г.Р.2021Aliyeva G.R.Алиева Г.Р.http://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/61532

Chronic pancreatitis remains an unsolved problem for clinicians. One of the biggest dilemmas is to establish a clear diagnosis. Diagnosis can be particularly elusive in patients with early chronic pancreatitis. Many studies have been undertaken to improve diagnostics in chronic pancreatitis, but this has been significantly limited by the lack of a “gold standard”. The evaluation of patients with suspected chronic pancreatitis should follow a progressively non-invasive to more invasive approach. Computed tomography is the best primary imaging modality to obtain as it has good sensitivity for severe chronic pancreatitis and may exclude the need for other diagnostic tests. When ambiguous results are obtained, a magnetic resonance cholangiopancreatography may require for a more detailed evaluation of both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, endoscopic ultrasound with or without pancreas function testing becomes the preferred method. Endoscopic retrograde cholangiopancreatography remains a last line diagnostic test and generally should be used only for diagnostic purposes. Future researches in the field of diagnosis of early-stage chronic pancreatitis should purpose optimizing current diagnostic tools. A definitive diagnosis of chronic pancreatitis may not be made simply by clinical history, imaging or function testing alone, but rather by the data gathered by a combination of these diagnostic tools.

Хронический панкреатит остаётся нерешённой задачей для врачей. Одна из самых больших дилемм — ¬поставить чёткий диагноз. Диагностика может быть особенно сложной у пациентов с ранним хроническим панкреатитом. Проведены многочисленные исследования, направленные на улучшение диагностики хронического панкреатита, но в связи с отсутствием «золотого стандарта» все они значительно ограничены. ¬Обследование пациентов с подозрением на хронический панкреатит следует осуществлять пошагово от неинвазивного метода исследования к более инвазивному. Компьютерная томография служит лучшим методом первичной визуализации, поскольку имеет хорошую чувствительность при тяжёлом хроническом панкреатите и может исключить необходимость в других диагностических исследованиях. В случае неоднозначности результатов для более детальной оценки как паренхимы, так и протоков поджелудочной железы приемлемо использование магнитно-резонансной холангиопанкреатографии. При сомнительном диагнозе методом предпочтения становится эндоскопическая эндосонография с тестированием функций поджелудочной железы или без него. Эндоскопическая холангиопанкреатография остаётся последним методом диагностики, в основном её необходимо использовать исключительно в диагностических целях. Дальнейшие исследования в области диагностики хронического панкреатита на ранней стадии должны быть направлены на оптимизацию существующих диагностических методов исследования. Окончательный диагноз хронического панкреатита может быть поставлен не только на основании анамнеза заболевания, методов визуализации или функционального тестирования, но скорее на основании данных, собранных с помощью совокупности всех диагностических методов.

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