Clinical Course and Prognosis of Chronic Pancreatitis

Miyake, Hirofumi; Harada, Hideo; Kunichika, Keizo; Ochi, Koji; Kimura, Ikuo

doi:10.1097/00006676-198707000-00003

Cited by 118 publications

(80 citation statements)

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“…These guidelines explain how to guide patients to abstinence using a flow diagram [63][64][65]. In addition, smoking increases the risks of developing chronic pancreatitis and pancreatic calcification.…”

Section: Lifestyle Guidancementioning

confidence: 99%

“…In addition, patients with chronic pancreatitis constitute a high-risk group for ordinary-type pancreatic cancer [73][74][75]. Although clear evidence for testing is lacking, many patients with chronic pancreatitis lead a lifestyle associated with carcinogenic risks (alcohol drinking and/or smoking), and it is useful to perform cancer screening [65,[76][77][78][79][80][81].…”

Section: Pain Managementmentioning

confidence: 99%

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Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

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Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

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Section: Lifestyle Guidancementioning

confidence: 99%

Section: Pain Managementmentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

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“…Periductal fibrosis, ductal dilatation with foci of calcification, and acinar-to-ductal metaplasia are also commonly seen (3). As a consequence, exocrine deficiency can occur, as can endocrine deficiency, although this usually occurs later in the course of the disease (4)(5)(6).…”

mentioning

confidence: 99%

Increased Chromogranin A–Positive Hormone-Negative Cells in Chronic Pancreatitis

Moin

Cory

Choi

et al. 2018

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Chronic pancreatitis (CP) is characterized by inflammation, fibrosis, and a loss of pancreatic acinar cells, which can result in exocrine and eventually endocrine deficiency. Pancreatitis has been reported to induce formation of new endocrine cells (neogenesis) in mice. Our recent data have implicated chromogranin A-positive hormone-negative (CPHN) cells as potential evidence of neogenesis in humans.Objective: We sought to establish if CPHN cells were more abundant in CP in humans.Design, Setting, and Participants: We investigated the frequency and distribution of CPHN cells and the expression of the chemokine C-X-C motif ligand 10 (CXCL10) and its receptor chemokine C-X-C motif receptor 3 in pancreas of nondiabetic subjects with CP.Results: CPHN cell frequency in islets was increased sevenfold in CP [2.1% 6 0.67% vs 0.35% 6 0.09% CPHN cells in islets, CP vs nonpancreatitis (NP), P , 0.01], as were the CPHN cells found as scattered cells in the exocrine areas (17.4 6 2.9 vs 4.2 6 0.6, CP vs NP, P , 0.001). Polyhormonal endocrine cells were also increased in CP (2.7 6 1.2 vs 0.1 6 0.04, CP vs NP, % of polyhormonal cells of total endocrine cells, P , 0.01), as was expression of CXCL10 in a and b cells. Conclusion:There is increased islet endogenous expression of the inflammation marker CXCL10 in islets in the setting of nondiabetic CP and an increase in polyhormonal (insulin-glucagon expressing) cells. The increase in CPHN cells in CP, often in a lobular distribution, may indicate foci of attempted endocrine cell regeneration. (J Clin Endocrinol Metab

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“…In terms of QOL, 69% of patients were professionally rehabilitated and in 72% of patients the Karnofsky index was between 90% and 100% [46]. Death rates in patients with CP who have undergone Beger procedure at 5 years of follow-up have been reported to be 9-12.6% [46,47], which is in contrast to the reported mortality of 20-35% in patients of CP without treatment who were observed over a period of 6-10 years [48][49][50]. This supports the long-term benefits of Beger procedure.…”

Section: Resectional Proceduresmentioning

confidence: 83%

Surgery for Chronic Pancreatitis

Perwaiz¹,

Singh²,

Chaudhary³

2011

Indian J Surg

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Chronic pancreatitis (CP) is progressive inflammatory process of the pancreas. Abdominal pain remains the most debilitating symptom affecting quality of life, apart from diabetes mellitus, steatorrhoea and weight loss. The treatment options have evolved over the past decades and are aimed to provide durable relief in pain with possible attempt to support or improve the failing endocrine and exocrine functions. Surgical treatment options have shown the potentials to provide superior long term results compared to the pharmacological and endoscopic modalities and are broadly divided in to drainage, resection and combination hybrid procedures. The choice is based on the morphology of the main pancreatic duct, presence of head mass and associated complication of CP. Knowing the basic nature of the disease, total pancreatectomy seems a curative option but not without significant morbidities. There is recent paradigm shift towards organ sparing surgical procedures with reasonable success. Despite recent advancement in the treatment modalities for CP the overall quality of life remains moderate which need further addressal.

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Clinical Course and Prognosis of Chronic Pancreatitis

Cited by 118 publications

References 0 publications

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Increased Chromogranin A–Positive Hormone-Negative Cells in Chronic Pancreatitis

Surgery for Chronic Pancreatitis

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