在傳統的定義上慢性胰臟炎是指永久性不可逆轉的胰臟傷害。這些傷害同時造成結構以 及功能的異常，包括：慢性發炎、纖維化、脂肪瀉、以及糖尿病。慢性胰臟炎的治療主要在 於症狀的緩解。腹痛是最常見的臨床症狀，也是最常見減少生活品質的因素。腹痛的治療包 括：止痛藥、抗氧化劑、胰臟酵素治療、以及內視鏡治療。內視鏡治療的目的是藉由減少胰 管的阻塞增加胰液的引流。然而，內視鏡的治療常受限於胰管的解剖構造。近年來，內視鏡 的治療配合體外震波碎石術(extracorporeal shock-wave lithotripsy, ESWL) 可以增加胰管結石的 移除率以及疼痛的控制。消化不良(maldigestion) 發生在胰脂肪酶分泌量小於正常量10% 的時 候。胰臟酵素治療是主要治療脂肪瀉的方式。胰臟酵素治療失敗通常是多重因素的，包括： 劑量不足、病人順從性不佳、藥物劑型不佳、或是伴隨有其他疾病。糖尿病在慢性胰臟炎的 病人所使用的胰島素劑量，通常比一般胰島素阻抗的第二型糖尿病來的少。在慢性胰臟炎的 糖尿病人低血糖的風險較高，需要小心照看。雖然慢性胰臟炎有許多的治療的方式，但是成 功的治療需要病人良好的順從性配合。

The traditional definition of chronic pancreatitis (CP) has been permanent and irreversible damage to the pancreas. The damages resulted in both structure and functional abnormalities, including chronic inflammation, fibrosis, steatorrhea and diabetes. The treatment of CP is mainly focused on the symptoms. Abdominal pain is the most common clinical problem and decreased the quality of life. The treatments for pain control included analgesics, antioxidants, pancreatic enzyme therapy, octreotide and endoscopic treatment. The general goal of endoscopic therapy is to improve drainage of the pancreatic duct by relieving ductal obstruction. However, endoscopic treatment is limited due to the pancreatic ductal anatomy. In recent years, the combination of endoscopic treatment and extracorporeal shock-wave lithotripsy (ESWL) improved the success rate of pancreatic duct stone removal and pain control. Maldigestion occurred when approximately 10% of the normal pancreatic output of lipase. Pancreatic enzyme therapy is mainly the solution for steatorrhea. The failure of enzyme replacement therapy is multi-factorial, including inadequate dose, noncompliance, inadequate formulation, and associated with other underlying disease. Diabetes mellitus is an independent risk factor of mortality in chronic pancreatitis. The dose of insulin in chronic pancreatitis is usually lower than insulin-resistant type 2 diabetes mellitus, and the risk of treatment-induced hypoglycemia should be carefully monitored. Although multiple treatment modalities are used in the treatment of chronic pancreatitis, the successful management of chronic pancreatitis relied on the good compliance of patient. (J Intern Med Taiwan 2016; 27: 190-194)