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

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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.	王洛偉, 李兆申. 慢性胰腺炎研究進展[J]. 世界華人消化雜志, 2007, 15(34):3598-3603.
2.	中華胰腺病雜志編委會, 中華醫學會消化內鏡學分會.慢性胰腺炎診治指南(2012,上海)[J]. 中華消化內鏡雜志, 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.	錢家鳴. 慢性胰腺炎的病因[J]. 胃腸病學, 2001, 6(3):173-174.
9.	錢家鳴, 李景南, 呂紅, 等. 酒精性與膽源性慢性胰腺炎的臨床特點的異同[J]. 中華消化雜志, 2002, 22(3):141-143.
10.	張海蓉, 耿瓊梅, 段麗平. 慢性胰腺炎430例診治分析[J]. 重慶醫學, 2012, 41(29):3054-3055, 3058.
11.	王洛偉, 李兆申, 李淑德, 等. 慢性胰腺炎全國多中心流行病學調查[J]. 胰腺病學, 2007, 7(1):1-5.
12.	王洛偉, 李兆申, 方裕強, 等. 慢性胰腺炎診斷與治療臨床研究(附262例分析)[J]. 解放軍醫雜志, 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.	畢青. 慢性胰腺炎58例臨床特點及診療分析[J]. 安徽醫藥, 2004, 8(4):272-273.
15.	劉續寶. 慢性胰腺炎的診斷和治療[J]. 中國普外基礎與臨床雜志, 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.	吳愛蘭, 韓萍, 馮敢生, 等. 胰腺癌與慢性胰腺炎的CT診斷[J]. 同濟醫科大學學報, 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. 第三講胰腺疾病內鏡治療研究進展[J]. 中華消化雜志, 2001, 21(3):171-173.
22.	劉俊. 慢性胰腺炎的內鏡介入治療[J]. 臨床消化病雜志, 2007, 19(6):348-350.
23.	R?sch 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.	郭靜會, 張順財. 慢性胰腺炎臨床特征研究(附57例分析)[J]. 中華現代內科學雜志, 2008, 5(3):193-196.

1. 王洛偉, 李兆申. 慢性胰腺炎研究進展[J]. 世界華人消化雜志, 2007, 15(34):3598-3603.
2. 中華胰腺病雜志編委會, 中華醫學會消化內鏡學分會.慢性胰腺炎診治指南(2012,上海)[J]. 中華消化內鏡雜志, 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. 錢家鳴. 慢性胰腺炎的病因[J]. 胃腸病學, 2001, 6(3):173-174.
9. 錢家鳴, 李景南, 呂紅, 等. 酒精性與膽源性慢性胰腺炎的臨床特點的異同[J]. 中華消化雜志, 2002, 22(3):141-143.
10. 張海蓉, 耿瓊梅, 段麗平. 慢性胰腺炎430例診治分析[J]. 重慶醫學, 2012, 41(29):3054-3055, 3058.
11. 王洛偉, 李兆申, 李淑德, 等. 慢性胰腺炎全國多中心流行病學調查[J]. 胰腺病學, 2007, 7(1):1-5.
12. 王洛偉, 李兆申, 方裕強, 等. 慢性胰腺炎診斷與治療臨床研究(附262例分析)[J]. 解放軍醫雜志, 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. 畢青. 慢性胰腺炎58例臨床特點及診療分析[J]. 安徽醫藥, 2004, 8(4):272-273.
15. 劉續寶. 慢性胰腺炎的診斷和治療[J]. 中國普外基礎與臨床雜志, 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. 吳愛蘭, 韓萍, 馮敢生, 等. 胰腺癌與慢性胰腺炎的CT診斷[J]. 同濟醫科大學學報, 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. 第三講胰腺疾病內鏡治療研究進展[J]. 中華消化雜志, 2001, 21(3):171-173.
22. 劉俊. 慢性胰腺炎的內鏡介入治療[J]. 臨床消化病雜志, 2007, 19(6):348-350.
23. R?sch 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. 郭靜會, 張順財. 慢性胰腺炎臨床特征研究(附57例分析)[J]. 中華現代內科學雜志, 2008, 5(3):193-196.

West China Medical Journal

Clinical Features of Chronic Pancreatitis

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