Alcohol and Smoking in Chronic Pancreatitis

Masamune, Atsushi; Kikuta, Kazuhiro; Kaneda, Kiyoshi

doi:10.1002/9781119876007.ch48

Cited by 1 publication

(3 citation statements)

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“…Japan's 2009 clinical diagnostic criteria for early-stage CP were modified in 2019 7 and now state that cases must display at least 3 of the following signs and symptoms: (1) persistent upper abdominal or back pain, (2) abnormal levels of pancreatic enzymes in the blood/urine, (3) pancreatic exocrine dysfunction, (4) continuing alcohol intake of over 60 g/d or abnormality in pancreatitis-related genes, and (5) a history of acute pancreatitis. In addition, the cases satisfying EUS, ERCP, or MRCP findings and displaying ECP are defined as confirmed cases, whereas those only satisfying 2 of the 5 conditions and satisfying EUS/ERCP/ MRCP findings are defined as suspected cases.…”

Section: Discussionmentioning

confidence: 99%

“…The findings similar to ECP by EUS were assessed in accordance with Japan's 2019 clinical diagnostic criteria for CP. 7 Four criteria, for the assessment of the pancreatic parenchyma (hyperechoic foci [nonshadowing] or strands [Hyp] and lobularity [Lob]), and for the pancreatic duct (hyperechoic margin of the pancreatic duct [H-MPD] and dilated side branches of the pancreatic duct [Dil]), were classified and scored as − (absent) or + (present). Concerning the EUS findings (overall), the presence of 2 or more of the 4 findings, including either Hyp or Lob, was scored as + (present) and otherwise as − (absent).…”

Section: Endoscopic Ultrasonographymentioning

confidence: 99%

“…Endoscopic ultrasonography findings of the diagnostic criteria for early-stage CP were slightly modified in 2019. 7 They define CP as the presence of 2 or more of the 4 findings, including the following (1) or ( 2): (1) hyperechoic (nonshadowing) foci or strands, (2) lobularity, (3) hyperechoic margin of the pancreatic duct, and (4) dilated pancreatic branch ducts. However, these were partially extracted from the Rosemont classification based on clinical experience; that is, pathological evidence was not included.…”

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confidence: 99%

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A Comparative Study of Endoscopic Ultrasonography and Histopathology Images for the Diagnosis of Early Chronic Pancreatitis

Sekine

M²,

Miura

et al. 2021

Pancreas

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Objective: The concept of early chronic pancreatitis (ECP) and its diagnostic criteria were first proposed by Japan, using endoscopic ultrasonography (EUS) findings for diagnosis. However, these findings have not been supported by pathological findings. We aimed to examine the association between the EUS and pathological findings of the same area of the pancreas. Methods:In 12 patients who underwent pancreaticoduodenectomy for distal bile duct cancer without accompanying pancreatitis, a comparative analysis between preoperative EUS and pathological findings was performed. The part of the pancreas adjoining the portal vein was evaluated.Results: In 7 cases, abnormal EUS findings included in the diagnostic criteria for ECP were seen; the correlation of the accuracy of lobularity seen on EUS compared with the pathological findings of the pancreatic parenchyma (inflammatory cell infiltration, atrophy of acinar cells, and fibrosis) was high (83.3%-91.7%). Pancreatic duct findings revealed that the accuracy of the hyperechoic margin of the pancreatic duct on EUS compared with pathological findings (wall thickness of pancreatic duct) was high (83.3%).Conclusions: Endoscopic ultrasonography findings for ECP, according to Japan's 2019 revised criteria, lobularity, and the hyperechoic margin of the pancreatic duct may highly correspond to the pathological findings of chronic inflammation.

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Section: Discussionmentioning

confidence: 99%

Section: Endoscopic Ultrasonographymentioning

confidence: 99%

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confidence: 99%

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