Pancreatic volume does not correlate with histologic fibrosis in adult patients with recurrent acute and chronic pancreatitis |
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| Affiliation: | 1. Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA;2. Pancreatitis Center, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA;3. Sidney Kimmel Comprehensive Cancer Center, Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;4. Division of Gastrointestinal, Liver and Pancreatic Pathology, Department of Pathology, University of Pennsylvania, Perelman, School of Medicine, philadelphia, USA;5. Division of Abdominal Imaging, Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;6. Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine Johns Hopkins Medical Institutions, Baltimore, MD, USA;7. Division of Transplant Surgery, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA;8. Division of Surgical Oncology, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA;9. The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;1. Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India;2. Radiodiagnosis (GE Radiology), Post Graduate Institute of Medical Education and Research, Chandigarh, India;3. Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India;4. Clinical Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India;5. Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India;6. Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India;1. Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;2. Departments of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;3. Departments of Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;1. Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Centre Hospitalier Universitaire, Université de Rennes 1, Rennes, France;2. Service d''Imagerie Médicale, Hôpital Pontchaillou, Université de Rennes 1, Rennes, France;3. INSERM UMR991, Foie, Métabolismes et Cancer, Université de Rennes 1, Rennes, France |
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| Abstract: | ObjectivesReduced pancreatic volume, often referred to as atrophy, is a commonly reported imaging feature of chronic pancreatitis (CP). This study evaluated whether there is an association between pancreatic volume and fibrosis, the criterion standard of CP, in patients undergoing total pancreatectomy with islet autotransplantation (TPIAT) for recurrent acute pancreatitis (RAP) and CP.MethodsAll adult patients who underwent TPIAT between 2010 and 2019 were categorized into 3 groups: RAP, definite CP and indeterminate CP. Pancreatic volume was calculated by summing up the areas from each thin section of the pancreas on 3D CT imaging. Excisional biopsies of the pancreatic head as well as body/tail region were obtained at the time of TPIAT. Two different fibrosis scores were used for histologic assessment.ResultsA total of 16, 29 and 15 patients underwent TPIAT for RAP, definite CP and indeterminate CP, respectively. The mean pancreatic volumes for patients with RAP, definite CP and indeterminate CP were 65.7 ± 28.5 cc, 54.9 ± 22.9 cc and 61.8 ± 23.6 cc, respectively (p = 0.3). The mean fibrosis scores were significantly higher in patients with definite CP compared to RAP (p < 0.001) and indeterminate CP (p < 0.001). Pancreatic volume was not associated with either fibrosis score after adjusting for age, gender, duration of disease, BMI and diabetes in the multivariable analysis.ConclusionsWhile the fibrosis scores were higher in definite CP compared to both RAP and indeterminate CP, there was no correlation between pancreatic volume and fibrosis. This suggests that atrophy alone cannot be used to diagnose CP. |
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| Keywords: | Chronic pancreatitis Recurrent acute pancreatitis Pancreatic volume Pancreatic atrophy TPIAT |
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