**1. Introduction**

Chronic pancreatitis (CP) is a relapsing inflammatory disease characterized by pain, fibrotic strictures in the pancreatic and biliary ducts, calculi in the pancreatic duct, and an increased malignancy risk. Abdominal pain, weight loss, nausea, diarrhea, oily stools, and bloating are the main symptoms of this disease. Exocrine and endocrine insufficiency generally occurs during the late phases of the disease. The annual incidence rate is 5–12/100,000 people [1]. Alcohol consumption is the most common cause, accounting for approximately 65% of all cases [2]. Hereditary factors, congenital anatomical abnormalities, such as pancreas divisum or annulare, and autoimmune inflammation may play a role in the etiology.

Pain, which decreases the quality of life and causes high healthcare costs, is the main indication for endoscopic treatment when lifestyle changes and medical treatment fail. The first treatment step is the cessation of alcohol use and smoking for pain management, followed by the World Health Organization algorithm. Analgesics are

the cornerstone at the beginning; however, when opioids are used, they may cause dependency, opioid-induced constipation, cognitive dysfunction, and opioid-induced hyperalgesia. In such cases, patients should be evaluated by a multidisciplinary team.

As interventional techniques are widely feasible and accepted, they play an important role in managing hepatobiliary diseases. Early diagnosis of CP is possible using endoscopic ultrasound (EUS)-based approaches, and interventional endoscopy can improve the complications of CP. In this chapter, we emphasize the use and importance of endoscopic modalities in the diagnosis and treatment of CP.
