Histopathological Changes in Liver of Patients With Chronic Pancreatitis Requiring Surgical Intervention and Their Clinical Significance

Abstract

ObjectivesThe histopathological changes in the liver and their clinical implication in chronic pancreatitis (CP) have not been studied well. We analyzed the incidence, risk factors, and long-term outcomes of these changes in CP.MethodsChronic pancreatitis patients who underwent surgery with intraoperative liver biopsy from 2012 to 2018 formed the study group. Based on liver histopathology, 3 groups were formed: normal liver, group NL; fatty liver, group FL; and inflammation/fibrosis, group FS. The risk factors and long-term outcomes, including mortality, were evaluated.ResultsAmong 73 patients, 39 (53.4%) had idiopathic, and 34 (46.6%) had alcoholic CP. The median age was 32 years, 52 (71.2%) were males and comprised NL, n = 40 (55%); FL, n = 22 (30%); and FS, n = 11 (15%). The preoperative risk factors were comparable among NL and FL groups. Overall 14 of 73 patients (19.2%) (NL, 5 of 40; FL, 5 of 22; FS, 4 of 11 [P = 0.82]) had died at median follow-up of 36 months (range, 25–85 months). The main causes of mortality were tuberculosis and severe malnutrition secondary to pancreatic insufficiency.ConclusionsThe mortality is higher in patients with inflammation/fibrosis or steatosis in liver biopsy, and such patients need monitoring for progression of liver disease and pancreatic insufficiency.

An observational study on the prevalence of choledochal cyst with pancreatitis: Geographical implications and management

“…In one case report, a remnant CDC stump was responsible for recurrent pancreatitis with a calculus in the head of the pancreas, necessitating excision of the stump and a proximal pancreatico‐duodenectomy 13 . As expected, the other two studies are from India; one reports the incidence of CDC with chronic pancreatitis as 2%, 14 and the other describes the management in three patients who required simultaneous surgery for both 15 …”

“…13 As expected, the other two studies are from India; one reports the incidence of CDC with chronic pancreatitis as 2%, 14 and the other describes the management in three patients who required simultaneous surgery for both. 15 This study is the first to characterize chronic pancreatitis in children with CDC. The strengths of the study include clearly delineating pancreatitis within the group of children with CDC and analyzing risk factors for a more stringent definition that included both radiological and biochemical parameters.…”