Non-pharmacological pain palliation methods in chronic pancreatitis

Table 1 Table provides an overview of various treatment methods for chronic pancreatitis, summarizing key points for each approach

Treatment method	Key points
Surgical intervention	Careful planning to prevent permanent and autonomous pain
	Priority on pain treatment to avoid chronic opioid use
	Optimal timing depends on patient and disease factors. Early surgery may result in greater pain alleviation
Surgical procedures	Goal: Clear pancreatic and bile duct obstructions
	Two types: Drainage operations and resection treatments
	Evolution from drainage to resection and hybrid procedures
Minimally invasive procedures	Laparoscopic and robotic techniques as options
	Robotic techniques lack conclusive evidence over open surgery
Endoscopic interventions	Endoscopic therapy as a first, less intrusive option
	Pancreatic duct stenting for relief in CP with strictures
Celiac plexus blocking	Commonly used for pain therapy, but effectiveness data lacking
	Endoscopic ultrasound-guided celiac plexus block reserved for selected cases
Acupuncture and PNS	PNS a viable treatment for CP pain
	Acupuncture shows promise as a complementary therapy. Further research needed
ESWL	ESWL alone or with ERCP based on individual characteristics
	Endoscopic treatment recommended post-ESWL in specific cases

PNS: Percutaneous electric nerve stimulation; ESWL: Extracorporeal Shock-Wave Lithotripsy; ERCP: Endoscopic retrograde cholangiopancreatography; CP: Chronic pancreatitis.