Course of alcoholic chronic pancreatitis: A prospective clinicomorphological long-term study

Ammann, R; Pu, Heitz; Klöppel, Günter

doi:10.1053/gast.1996.v111.pm8698203

Cited by 330 publications

(228 citation statements)

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“…versy for the past 40 years (8,9,13,14). The former studies on the covariation of function and morphology (15) and ERCP (16) in CP are of interest but, in contrast to our study (1), no data were provided regarding these alterations in relation to the evolution of CP from onset.…”

Section: Introductionmentioning

confidence: 62%

“…The average survival of ACP-patients 15-20 years from onset is 50% and most of them die at a mean age of54 years (1,25). Mortality is not directly related to ACPand its complications in about 80% of patients (1,8,18,25); the most common causes of death are due to heavy smoking (e.g. extrapancreatic malignancy, cardio-vascular or sudden death) and/or alcohol abuse (i.e.…”

Section: Impact Of Alcohol Smoking and Additional Factors On The Coumentioning

confidence: 99%

“…Unfortunately, data on the natural history are scarce and conflicting. Chronic alcohol abuse is the major etiological factor of CP in industrialized countries accounting for about 70% of patients (1). Nevertheless, it has become clear that the development of pancreatitis is not simply due to the amount and type of alcohol consumed.…”

Section: Introductionmentioning

confidence: 99%

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The Natural History of Alcoholic Chronic Pancreatitis.

Ammann

2001

Intern. Med.

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An improved knowledge of the natural history is the indispensible basis for a rational concept in regard to the diagnosis, classification, understanding and management of pain in chronic pancreatitis. Unfortunately, data on the natural history of CPare scarce and conflicting. Somerelevant observations of our prospective long-term study of a mixed medical-surgical cohort comprising 207 patients with alcoholic CP (mean follow-up 17 years from onset) are summarized. In early-stage CP, episodes of recurrent pancreatitis were predominant. Severe persistent pain was typically associated with local complications (mainly postnecrotic cysts in 54%; symptomatic cholestasis in 24%) relieved definitely by a drainage procedure. Lasting pain remission was documented in >80%of the whole cohort within 10 years from onset in association with marked pancreatic dysfunction. Fromour experience, the relief of "chronic" pain regularly follows selective surgery tailored to the presumptive pain cause or it occurs spontaneously in uncomplicated advanced CP (excluding narcotic addiction). (Internal Medicine 40: 368-375, 2001).

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Section: Introductionmentioning

confidence: 62%

Section: Impact Of Alcohol Smoking and Additional Factors On The Coumentioning

confidence: 99%

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The Natural History of Alcoholic Chronic Pancreatitis.

Ammann

2001

Intern. Med.

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“…Abstinence from alcohol is an important factor influencing pain in patients with alcoholic pancreatitis. Abstainers have a slower rate of deterioration of pancreatic function and a better response to pain control by therapy than nonabstainers [18,[34][35][36][37][38][39][40].…”

Section: C3mentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

166

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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“…A critical early step towards understanding the pathogenesis of chronic pancreatitis is to develop an evidence-based staging system. A prospective study of chronic pancreatitis progression revealed that pancreatic dysfunction closely paralleled the degree of fibrosis, indicating that chronic pancreatitis is a progressive disorder and that specific histopathological changes correlate with worsening disease 1 . Once histopathological changes can be reliably correlated with clinical presentation and disease prognosis, an evidence-based protocol for the treatment of chronic pancreatitis can be developed based on clinical factors rather than the largely empirical approach currently employed.…”

Section: Total Pancreatectomy and Islet Autotransplantation For Chronmentioning

confidence: 99%

Systematic review of total pancreatectomy and islet autotransplantation for chronic pancreatitis

Bramis

Gordon-Weeks

Friend

et al. 2012

British Journal of Surgery

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Background: Total pancreatectomy and islet autotransplantation (TP/IAT) is a treatment option in a subset of patients with chronic pancreatitis. A systematic review of the literature was performed to evaluate the outcome of this procedure, with an attempt to ascertain when it is indicated. The impact on quality of life was poorly reported. The studies reviewed did not provide evidence for optimal timing of TP/IAT in relation to the evolution of chronic pancreatitis. Conclusion:This systematic review showed that TP/IAT had favourable outcomes with regard to pain reduction. Concurrent IAT enabled a significant proportion of patients to remain independent of insulin supplementation.

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Course of alcoholic chronic pancreatitis: A prospective clinicomorphological long-term study

Cited by 330 publications

References 0 publications

The Natural History of Alcoholic Chronic Pancreatitis.

The Natural History of Alcoholic Chronic Pancreatitis.

Italian consensus guidelines for chronic pancreatitis

Systematic review of total pancreatectomy and islet autotransplantation for chronic pancreatitis

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