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

Abstract

BackgroundChronic 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).MethodsCP 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.ResultsA 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.ConclusionThe 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.

ESPEN guideline on clinical nutrition in acute and chronic pancreatitis

“…There are differences in the onset of pancreatic insufficiency and malnutrition between patients with alcoholic and idiopathic CP. The latency between onset of first symptoms and signs of CP, including pain and malabsorption/malnutrition is between five to ten years in alcoholic, but delayed in non-alcoholic pancreatitis [94].…”

Descripción clínica y epidemiológica de pacientes con pancreatitis crónica en un hospital de alta complejidad en Cali, 2011 a 2017

“…En relación con la etiología, se reportó PC idiopática en más de la mitad de la población. En China en 2018 se realizó un censo con 2037 pacientes, de los cuales el 80,2 % de los casos fue por etiología idiopática y 19,8 % por etiología alcohólica (35). Estos resultados coinciden con los hallazgos de este estudio.…”

“…La PC se desarrolla a partir de la interacción de estos factores (7,19) y es individual y diferente en cada paciente. Las etiologías más frecuentes en series mundiales con rangos amplios son la alcohólica e idiopática (1,27,33,35,37,38). Estudios recientes han considerado el consumo de alcohol y tabaco como los factores más influyentes para PC (1,19,27,39,40).…”

Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

“…19,[21][22][23][24][25] The Changhai CP Database (version number 2.1, Yinma Information Technology Inc., Shanghai, China) was established to collect the clinical data of CP patients who were admitted to Changhai Hospital since 2005. The electronic medical record system (Goodwill Inc., Beijing, China) was used in Changhai Hospital (Shanghai, China) since 1990s.…”

“…[12][13][14] However, for CP without a recognized cause, which is idiopathic chronic pancreatitis (ICP), no appropriate method can be applied to delay the occurrence of pancreatic endocrine disfunction. [18][19][20] Therefore, identification risk factors for DM in ICP patients are of great significance, which may help in the early diagnosis and glucose control for CP patients with DM. [15][16][17] It is reported that DM occurs in 23.4% to 27.4% of ICP patients.…”