Aetiological risk factors are associated with distinct imaging findings in patients with chronic pancreatitis: A study of 959 cases from the Scandinavian Baltic Pancreatic Club (SBPC) imaging database

Engjom, Trond; Nordaas, Ingrid Kvåle; Tjora, Erling; Haldorsen, Ingfrid Salvesen; Olesen, Søren Schou; Drewes, Asbjørn Mohr; Žvinienė, Kristina; Barauskas, Giedrius; Jespersen, Hans Søe Riis; Jensen, Nanna M.; Borch, Anders; Nøjgaard, Camilla; Novovic, Srdan; Кардашева, С. С.; Okhlobystin, Alexey; Hauge, Truls; Waage, Anne; Frøkjær, Jens Brøndum

doi:10.1016/j.pan.2021.02.023

Cited by 5 publications

(9 citation statements)

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“…Excluding centers with low reporting rate for imaging data may have introduced a selection bias. In a previous publication from the same material, 17 we showed that patients excluded due to missing imaging registrations were older and more frequently had PEI and diabetes. Thus, this selection bias may have reduced the proportion of subjects with severe structural changes and complications.…”

Section: Discussionmentioning

confidence: 56%

“… 21 We found a negative association between diabetes and pseudocysts, possibly because pseudocysts are associated with shorter disease duration. 17 Diabetes was positively associated with structural changes affecting the entire pancreas, which may be related to displacement of healthy endocrine tissue. We found no association between pancreatic atrophy and diabetes in our material, though this has been reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 22 Moreover, smoking and alcohol abuse as etiologic risk factors have been associated with different patterns of structural pancreatic imaging findings. 17 , 18 Apart from calcifications, which have been associated with PEI, diabetes and reduced BMI, 10 , 11 , 20 knowledge on the relationship between pancreatic imaging findings and clinical outcome is sparse, particularly concerning the consequences of pancreatic atrophy.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of a patient exhibiting structural pancreatic changes increases with prolonged disease duration, 17 and so does the risk of PEI and diabetes. 36 Still, we found that disease duration was not independently associated with complications, and that it did not alter the associations between structural pancreatic changes and complications in CP.…”

Section: Discussionmentioning

confidence: 99%

“…Standardized definitions and instructions for reporting assessments were provided prior to the local review of imaging findings performed at the different sites. 16 We used the definition of pancreatic atrophy as previously suggested by our group, 17 using the sum of the anteroposterior diameters of the pancreatic head and body. Examples of structural pancreatic imaging changes are shown in Figure S1 .…”

Section: Methodsmentioning

confidence: 99%

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Structural imaging findings are related to clinical complications in chronic pancreatitis

et al. 2022

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Background/objectives Structural pancreatic changes and complications related to chronic pancreatitis are well described, but little is known about their relationship. We aimed to explore the associations between pancreatic morphology and clinical complications in a large chronic pancreatitis cohort. Methods The Scandinavian Baltic Pancreatic Club database collects registrations on patients with definite or probable chronic pancreatitis according to the M‐ANNHEIM diagnostic criteria. In this cross‐sectional study, we used multivariate logistic regression analyses to evaluate whether imaging‐based structural pancreatic changes were associated with common clinical complications. We adjusted for sex, age, disease duration, current alcohol abuse and current smoking. Results We included 742 patients with a mean age of 55 years. Among these, 68% were males, 69% had pancreatic exocrine insufficiency, 35% had diabetes, 12% were underweighted and 68% reported abdominal pain. Main pancreatic duct obstruction, severe (i.e. more than 14) calcifications, pancreatic atrophy and parenchymal changes throughout the entire pancreas (continuous organ involvement) were positively associated with pancreatic exocrine insufficiency. Continuous organ involvement and pseudocysts were positively and negatively associated with diabetes, respectively. Pancreatic atrophy and severe calcifications were positively associated with underweight, and severe calcifications were negatively associated with pain. Conclusions This study shows independent associations between distinct structural changes on pancreatic imaging and clinical complications in chronic pancreatitis. Pancreatic atrophy, severe calcifications and continuous organ involvement may be of particular clinical relevance, and these findings should motivate monitoring of pancreatic function and nutritional status.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%