Clinical Features of Chronic Pancreatitis_West China Medical Journal

Authors：

 FUDan

Department of Gastroenterology, the Sixth People's Hospital of Chengdu City, Chengdu, Sichuan 610051, P. R. China;

Corresponding author：

Keywords：

Chronic pancreatitis; Etiology; Clinical feature; Therapy

DOI：

10.7507/1002-0179.20140203

Video：

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Objective To evaluate the causes, clinical features, diagnosis and treatment of chronic pancreatitis (CP). Methods We retrospectively analyzed the clinical features of 47 patients with CP in the Sixth People's Hospital of Chengdu City from February 2008 to December 2011. Results There were 24 cases of biliary pancreatitis (51.1%), and 17 cases of alcoholic pancreatitis (36.2%). The clinical manifestations included abdominal pain in 40 patients (87.2%), diarrhea in 12 patients (25.5%), and diabetes mellitus in 13 patients (27.6%). Sixteen patients were diagnosed based on the ultrasonographic results (34.0%), 41 by computed tomography (CT) (87.2%), and 31 by endoscopic retrograde cholangiopancreatography (ERCP) (88.6%). Plain abdominal radiograph showed that 9 patients had calcification, mainly composed of Ⅰ and Ⅱ classes (44.7% and 51.1%), followed by class Ⅳ and stage 3. Management for chronic pancreatitis included medical treatment (10 cases, 21.2%) and surgical treatment (13 case, 27.6%), endoscopic treatment (24 cases, 51.6%). Conclusion The causes of chronic pancreatitis are biliary and alcoholic factors. Medical, endoscopic and surgical procedures are involved to treat chronic pancreatitis, especially for the relief of intractable chronic abdominal pain.

Citation： FUDan. Clinical Features of Chronic Pancreatitis. West China Medical Journal, 2014, 29(4): 672-675. doi: 10.7507/1002-0179.20140203 Copy

1.	王洛伟, 李兆申. 慢性胰腺炎研究进展[J]. 世界华人消化杂志, 2007, 15(34):3598-3603.
2.	中华胰腺病杂志编委会, 中华医学会消化内镜学分会.慢性胰腺炎诊治指南(2012,上海)[J]. 中华消化内镜杂志, 2012, 29(6):301-303.
3.	Dimagno MJ, Dimagno EP. Chronic pancreatitis[J]. Curr Opin Gastroenterol, 2010, 26(5):490-498.
4.	Gloor B, Ahmed Z, Uhl W, et al. Pancreatic disease in the elderly[J]. Best Pract Res Clin Gastroenterol, 2002, 16(1):159-170.
5.	Layer P, Yamamoto H, Kalthoff L, et al. The different courses of early-and late-onset idiopathic and alcoholic chronic pancreatitis[J]. Gastroenterology, 1994, 107(5):1481-1487.
6.	Etemad B, Whitcomb DC. Chronic pancreatitis:diagnosis, classification, and new genetic developments[J]. Gastroenterology, 2001, 120(3):682-707.
7.	Strate T, Knoefel WT, Yekebas E, et al. Chronic pancreatitis:etiology, pathogenesis, diagnosis, and treatment[J]. Int J Colorectal Dis, 2003, 18(2):97-106.
8.	钱家鸣. 慢性胰腺炎的病因[J]. 胃肠病学, 2001, 6(3):173-174.
9.	钱家鸣, 李景南, 吕红, 等. 酒精性与胆源性慢性胰腺炎的临床特点的异同[J]. 中华消化杂志, 2002, 22(3):141-143.
10.	张海蓉, 耿琼梅, 段丽平. 慢性胰腺炎430例诊治分析[J]. 重庆医学, 2012, 41(29):3054-3055, 3058.
11.	王洛伟, 李兆申, 李淑德, 等. 慢性胰腺炎全国多中心流行病学调查[J]. 胰腺病学, 2007, 7(1):1-5.
12.	王洛伟, 李兆申, 方裕强, 等. 慢性胰腺炎诊断与治疗临床研究(附262例分析)[J]. 解放军医杂志, 2002, 27(9):780-782.
13.	Chen WX, Zhang WF, Li B, et al. Clinical manifestations of patients with chronic pancreatitis[J]. Hepatobiliary Pancreat Dis Int, 2006, 5(1):133-137.
14.	毕青. 慢性胰腺炎58例临床特点及诊疗分析[J]. 安徽医药, 2004, 8(4):272-273.
15.	刘续宝. 慢性胰腺炎的诊断和治疗[J]. 中国普外基础与临床杂志, 2007, 14(4):385-387.
16.	Imoto M, Dimagno EP. Cigarette smoking increases the risk of pancreatic calcification in late-onset but not early-onset idiopathic chronic pancreatitis[J]. Pancreas, 2000, 21(2):115-119.
17.	Ikeda M, Sato T, Morozumi A, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey,with special reference to main duct dilation, cyst formation, and calcification[J]. Pancreas, 1994, 9(4):508-512.
18.	Choueiri NE, Balci NC, Alkaade S, et al. Advanced imaging of chronic pancreatitis[J]. Curr Gastroenterol Rep, 2010, 12(2):114-120.
19.	吴爱兰, 韩萍, 冯敢生, 等. 胰腺癌与慢性胰腺炎的CT诊断[J]. 同济医科大学学报, 2000, 29(4):353-355.
20.	Calvo MM, Bujanda L, Calderón A, et al. Comparison between magnetic resonance cholangiopancreatography and ERCP for evaluation of the pancreatic duct[J]. Am J Gastroenterol, 2002, 97(2):347-353.
21.	李兆申. 第三讲胰腺疾病内镜治疗研究进展[J]. 中华消化杂志, 2001, 21(3):171-173.
22.	刘俊. 慢性胰腺炎的内镜介入治疗[J]. 临床消化病杂志, 2007, 19(6):348-350.
23.	Rösch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis:a multicenter study of 1000 patients with long-term follow-up[J]. Endoscopy, 2002, 34(10):765-771.
24.	Bali MA, Sztantics A, Metens T, et al. Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography:normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis.Initial results[J]. Eur Radiol, 2005, 15(10):2110-2121.
25.	Delhaye M, Arvanitakis M, Verset G, et al. Long-term clinical outcome after endoscopic pancreatic ductal drainage for patients with painful chronic pancreatitis[J]. Clin Gastroenterol Hepatol, 2004, 2(12):1096-1106.
26.	Farkas G, Leinder L, Daróczi M, et al. Organ-preserving pancreatic head resection in chronic pancreatitis[J]. Br J Surg, 2003, 90(1):29-32.
27.	Sakorafas GH, Sarr MG, Rowland CM, et al. Postobstructive chronic pancreatitis:results with distal resection[J]. Arch Surg, 2001, 136(6):643-648.
28.	Hartel M, Tempia-Caliera AA, Wente MN, et al. Evidence-based surgery in chronic pancreatitis[J]. Langenbecks Arch Surg, 2003, 388(2):132-139.
29.	郭静会, 张顺财. 慢性胰腺炎临床特征研究(附57例分析)[J]. 中华现代内科学杂志, 2008, 5(3):193-196.

1. 王洛伟, 李兆申. 慢性胰腺炎研究进展[J]. 世界华人消化杂志, 2007, 15(34):3598-3603.
2. 中华胰腺病杂志编委会, 中华医学会消化内镜学分会.慢性胰腺炎诊治指南(2012,上海)[J]. 中华消化内镜杂志, 2012, 29(6):301-303.
3. Dimagno MJ, Dimagno EP. Chronic pancreatitis[J]. Curr Opin Gastroenterol, 2010, 26(5):490-498.
4. Gloor B, Ahmed Z, Uhl W, et al. Pancreatic disease in the elderly[J]. Best Pract Res Clin Gastroenterol, 2002, 16(1):159-170.
5. Layer P, Yamamoto H, Kalthoff L, et al. The different courses of early-and late-onset idiopathic and alcoholic chronic pancreatitis[J]. Gastroenterology, 1994, 107(5):1481-1487.
6. Etemad B, Whitcomb DC. Chronic pancreatitis:diagnosis, classification, and new genetic developments[J]. Gastroenterology, 2001, 120(3):682-707.
7. Strate T, Knoefel WT, Yekebas E, et al. Chronic pancreatitis:etiology, pathogenesis, diagnosis, and treatment[J]. Int J Colorectal Dis, 2003, 18(2):97-106.
8. 钱家鸣. 慢性胰腺炎的病因[J]. 胃肠病学, 2001, 6(3):173-174.
9. 钱家鸣, 李景南, 吕红, 等. 酒精性与胆源性慢性胰腺炎的临床特点的异同[J]. 中华消化杂志, 2002, 22(3):141-143.
10. 张海蓉, 耿琼梅, 段丽平. 慢性胰腺炎430例诊治分析[J]. 重庆医学, 2012, 41(29):3054-3055, 3058.
11. 王洛伟, 李兆申, 李淑德, 等. 慢性胰腺炎全国多中心流行病学调查[J]. 胰腺病学, 2007, 7(1):1-5.
12. 王洛伟, 李兆申, 方裕强, 等. 慢性胰腺炎诊断与治疗临床研究(附262例分析)[J]. 解放军医杂志, 2002, 27(9):780-782.
13. Chen WX, Zhang WF, Li B, et al. Clinical manifestations of patients with chronic pancreatitis[J]. Hepatobiliary Pancreat Dis Int, 2006, 5(1):133-137.
14. 毕青. 慢性胰腺炎58例临床特点及诊疗分析[J]. 安徽医药, 2004, 8(4):272-273.
15. 刘续宝. 慢性胰腺炎的诊断和治疗[J]. 中国普外基础与临床杂志, 2007, 14(4):385-387.
16. Imoto M, Dimagno EP. Cigarette smoking increases the risk of pancreatic calcification in late-onset but not early-onset idiopathic chronic pancreatitis[J]. Pancreas, 2000, 21(2):115-119.
17. Ikeda M, Sato T, Morozumi A, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey,with special reference to main duct dilation, cyst formation, and calcification[J]. Pancreas, 1994, 9(4):508-512.
18. Choueiri NE, Balci NC, Alkaade S, et al. Advanced imaging of chronic pancreatitis[J]. Curr Gastroenterol Rep, 2010, 12(2):114-120.
19. 吴爱兰, 韩萍, 冯敢生, 等. 胰腺癌与慢性胰腺炎的CT诊断[J]. 同济医科大学学报, 2000, 29(4):353-355.
20. Calvo MM, Bujanda L, Calderón A, et al. Comparison between magnetic resonance cholangiopancreatography and ERCP for evaluation of the pancreatic duct[J]. Am J Gastroenterol, 2002, 97(2):347-353.
21. 李兆申. 第三讲胰腺疾病内镜治疗研究进展[J]. 中华消化杂志, 2001, 21(3):171-173.
22. 刘俊. 慢性胰腺炎的内镜介入治疗[J]. 临床消化病杂志, 2007, 19(6):348-350.
23. Rösch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis:a multicenter study of 1000 patients with long-term follow-up[J]. Endoscopy, 2002, 34(10):765-771.
24. Bali MA, Sztantics A, Metens T, et al. Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography:normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis.Initial results[J]. Eur Radiol, 2005, 15(10):2110-2121.
25. Delhaye M, Arvanitakis M, Verset G, et al. Long-term clinical outcome after endoscopic pancreatic ductal drainage for patients with painful chronic pancreatitis[J]. Clin Gastroenterol Hepatol, 2004, 2(12):1096-1106.
26. Farkas G, Leinder L, Daróczi M, et al. Organ-preserving pancreatic head resection in chronic pancreatitis[J]. Br J Surg, 2003, 90(1):29-32.
27. Sakorafas GH, Sarr MG, Rowland CM, et al. Postobstructive chronic pancreatitis:results with distal resection[J]. Arch Surg, 2001, 136(6):643-648.
28. Hartel M, Tempia-Caliera AA, Wente MN, et al. Evidence-based surgery in chronic pancreatitis[J]. Langenbecks Arch Surg, 2003, 388(2):132-139.
29. 郭静会, 张顺财. 慢性胰腺炎临床特征研究(附57例分析)[J]. 中华现代内科学杂志, 2008, 5(3):193-196.

West China Medical Journal

Clinical Features of Chronic Pancreatitis

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