The revised Japanese clinical diagnostic criteria for chronic pancreatitis

Shimosegawa, Tooru; Kataoka, Keisuke; Kamisawa, Terumi; Miyakawa, Hiroyoshi; Ohara, Hirotaka; Ito, Tetsuhide; Naruse, Satoru; Sata, Naohiro; Suda, Koichi; Hirota, Morihisa; Takeyama, Yoshifumi; Shiratori, Keiko; Hatori, Takashi; Ōtsuki, Makoto; Atomi, Yutaka; Sugano, Kentaro; Tanaka, Masao

doi:10.1007/s00535-010-0242-4

Cited by 168 publications

(136 citation statements)

References 35 publications

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“…1) was prepared. When chronic pancreatitis is suspected, a diagnosis should be made according to the criteria for the diagnosis of chronic pancreatitis revised in 2009 [1]. Definitive and probable diagnosis of chronic pancreatitis can be made by imaging alone.…”

Section: Diagnosismentioning

confidence: 99%

“…However, the 2001 criteria for the diagnosis of chronic pancreatitis were revised to contain the category of early chronic pancreatitis in 2009 [1]. Therefore, in the Clinical Practice Guidelines newly revised in 2015, we have referred to the diagnosis of early phase lesions of chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009; in addition, we have described the advent of high-titer lipase formulations, which have been available in Japan since 2009, and the utility of low-fat elemental diets (ED) for patients with pain.…”

Section: Introductionmentioning

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: Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

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“…It is known that patients with chronic pancreatitis are at risk for pancreatic cancer, therefore, chronic pancreatitis should be diagnosed within reversible stage so that it can be cured by therapeutic intervention. At the current moment, EUS is considered to be the best imaging modality which can detect early chronic pancreatitis [67,68] . However, the diagnostic criteria used in EUS, such as hyperechoic foci and stranding, are associated with calcification which are irreversible change.…”

Section: Future Perspectivesmentioning

confidence: 99%

Elastography for the pancreas: Current status and future perspective

Kawada¹,

Tanaka²

2016

WJG

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Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. Core tip: Elastography for the pancreas had been considered to be difficult to perform with adequate accuracy and reproducibility because the pancreas is a small organ located deep in center of the human body. This review introduces the recent innovation of elastography for the pancreas, and makes recommendations on how to use various elastographic modalities for the pancreas. The review also shows us what we can know by performing elastography for the pancreas. Elastography may be a promising imaging modality for differential diagnosis between malignant and benign pancreatic tumors, for early diagnosis of chronic pancreatitis, and for identifying high-risk patients for pancreatic cancer. TOPIC HIGHLIGHTKawada N, Tanaka S. Elastography for the pancreas: Current status and future perspective.

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“…In some patients, additional examinations such as pancreatic exocrine function test (the N-benzoyl-L-tyrosyl-p-aminobenzoic acid test) [7], endoscopic ultrasonography, and endoscopic retrograde cholangiopancreatography were performed. Using the findings of these examinations, the diagnosis of CP (definitive, probable, early, and possible) was established according to the clinical diagnostic criteria proposed by the Japan Pancreas Society [8].…”

Section: Patientsmentioning

confidence: 99%

Medical Management of Chronic Pancreatitis: What Can Physicians Do?

Lee¹

2017

Korean J Pancreas Biliary Tract

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Background & Aims. Chronic pancreatitis (CP) is often associated with abdominal pain, which impairs quality of life. The aim of this prospective study was to clarify whether the use of a low-fat elemental diet (ED) is beneficial for managing pain in patients with CP. Methods. Seventeen CP patients with pain despite fat-restricted dietary and conventional medical treatments were enrolled in this prospective study. These patients received low-fat ED therapy in addition to restricting fat intake for 8 weeks. The change of pain severity was examined by interviewing the patient and status of analgesic use. Results. Mean serum levels of amylase and lipase at 8 weeks after the beginning of low-fat ED therapy decreased compared to those before the therapy. At 8 weeks, pain alleviation after low-fat ED therapy was reported in 15 out of 17 patients (88%). Of these 15 patients, 10 patients reported complete pain disappearance. One of 3 patients with severe or moderate pain requiring analgesic was relieved of analgesic use after low-fat ED therapy. Conclusion. Low-fat ED therapy is useful as means of pain control in CP. The therapy is recommended in outpatients with CP who present with pain despite conventional dietary and medical treatments.

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The revised Japanese clinical diagnostic criteria for chronic pancreatitis

Cited by 168 publications

References 35 publications

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Elastography for the pancreas: Current status and future perspective

Medical Management of Chronic Pancreatitis: What Can Physicians Do?

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