Research Article: The different course of alcoholic and idiopathic chronic pancreatitis: A long-term study of 2,037 patients

Date Published: June 8, 2018

Publisher: Public Library of Science

Author(s): Lu Hao, Li-Sheng Wang, Yu Liu, Teng Wang, Hong-Lei Guo, Jun Pan, Dan Wang, Ya-Wei Bi, Jun-Tao Ji, Lei Xin, Ting-Ting Du, Jin-Huan Lin, Di Zhang, Xiang-Peng Zeng, Wen-Bin Zou, Hui Chen, Ting Xie, Bai-Rong Li, Zhuan Liao, Zhi-Jie Cong, Zheng-Lei Xu, Zhao-Shen Li, Liang-Hao Hu, Francisco X. Real.

http://doi.org/10.1371/journal.pone.0198365

Abstract

Chronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas. This study aimed to compare the natural course of alcoholic chronic pancreatitis (ACP) and idiopathic chronic pancreatitis (ICP).

CP patients admitted to our center from January 2000 to December 2013 were enrolled. Characteristics were compared between ACP and ICP patients. Cumulative rates of diabetes mellitus (DM), steatorrhea, pancreatic stone, pancreatic pseudocyst, biliary stricture, and pancreatic cancer after the onset and the diagnosis of CP were calculated, respectively. The cumulative rates of DM and steatorrhea after diagnosis of pancreatic stone were also calculated.

A total of 2,037 patients were enrolled. Among them, 19.8% (404/2,037) were ACP and 80.2% (1,633/2,037) were ICP patients. ACP and ICP differs in many aspects, especially in gender, age, smoking, complications, morphology of pancreatic duct, and type of pain. The development of DM, steatorrhea, PPC, pancreatic stone, and biliary stricture were significantly earlier and more common in ACP patients. No significant difference was observed for pancreatic cancer development. There was a rather close correlation between exocrine/endocrine insufficiency and pancreatic stone in ACP patients, which was much less correlated in ICP patients.

The long-term profile of ACP and ICP differs in some important aspects. ACP patients usually have a more severe course of CP. These differences should be recognized in the diagnosis and treatment of CP.

Partial Text

Chronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas, which leads to a progressive and irreversible destruction of pancreatic parenchyme and ductal structures[1, 2]. Alcoholic chronic pancreatitis (ACP) patients were those abused alcohol; while idiopathic chronic pancreatitis (ICP) patients were those had no recognized causes of CP.

To our knowledge, this is a study about natural course of ACP and ICP based on the largest cohort of CP patients. In the present study, epidemiological features, initial manifestations, natural course and complications of CP were evaluated.

 

Source:

http://doi.org/10.1371/journal.pone.0198365

 

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