Coexistence of alcohol-related pancreatitis and alcohol-related liver disease: A systematic review and meta-analysis |
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| Affiliation: | 1. Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;2. Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, United States;3. Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;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. Laboratoire de Génétique et Biologie Moléculaires, Hôpital Cochin, APHP. Centre-Université de Paris, France;2. Service de Pancréatologie-Gastroentérologie, Pôle des Maladies de l’Appareil Digestif, Université Denis Diderot, Hôpital Beaujon, APHP, DHU UNITY, Clichy, France;3. Centre de Référence des Maladies Rares du Pancréas, PAncreaticRaresDISeases (PaRaDis), France;4. UMR1078 “Génétique, Génomique Fonctionnelle et Biotechnologies”, INSERM, EFS - Bretagne, Université de Brest, CHRU Brest, Brest, France;5. CHU Lille, Service de Toxicologie et Génopathies, Lille, France;1. Leeds Liver Unit, St James’s University Hospital, Leeds, United Kingdom;3. Department of Gastroenterology and Hepatology, University Hospital Marques de Valdecilla, Valdecilla Research Institute, Santander, Spain;4. Liver Center, Departments of Medicine and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;5. Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;7. Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;12. Department of Liver Medicine, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom;8. Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom;9. Department of Medicine, VA San Diego Healthcare System, University of California, San Diego, La Jolla, California;71. Liver Sciences, Dept of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King''s College London, London, United Kingdom;123. Cirrhosis Care Clinic, Division of Gastroenterology (Liver Unit), Centre of Excellence Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Alberta, Canada;84. Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin;95. Section of Digestive Diseases, VA Connecticut Healthcare System, West Haven, Connecticut;77. Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York;1212. Hospital San José Tecnológico de Monterrey. Universidad Autónoma de Nuevo León, Monterrey, México;88. Liver Unit, Hospital Vall d''Hebron, Universitat Autònoma Barcelona, CIBEREHD, Barcelona, Spain;1. ICU Center, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Furong, Changsha 410011, Hunan, China;2. Department of Respiratory, Anhui Provincial Hospital, No. 17 Luyang Road, Hefei 230011, Anhui, China;3. Department of Pediatrics, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Furong, Changsha 410011, Hunan, China;4. Department of Urology, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Furong, Changsha 410011, Hunan, China;1. New York University, Division of Gastroenterology and Hepatology, USA;2. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA;3. Albany Gastroenterology Consultants, USA;4. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;5. University of Pittsburgh, Center for Research on Health Care Data Center, USA;6. University of Pittsburgh, Department of Radiology, USA;7. University of Pittsburgh, Division of Surgical Oncology, USA;8. Ohio State University Wexner Medical Center, Division of Gastroenterology, Hepatology and Nutrition, USA |
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| Abstract: | BackgroundAvailable estimates of coexistent alcohol-related pancreatitis (ALP) and alcohol-related liver disease (ALD) vary widely, and factors that determine coexistent disease are largely unknown. We performed a systematic review of published literature with the primary aim to generate robust estimates for coexistent alcohol-related chronic pancreatitis (ACP) and alcohol-related cirrhosis (ALC).MethodsWe searched PubMed, EMBASE, and Web of Science databases from inception until February 2018. Studies included were those in English-language, sample size ≥25 and allowed calculation of the coexistent disease. Pooled estimates were calculated using a random-effects model approach.ResultsTwenty-nine (including 5 autopsy studies) of 2000 eligible studies met inclusion criteria. Only 6.9% included patients were female. Fifteen studies enabled calculation of ACP in ALC, and 11 for ALC in ACP. Pooled prevalence of ACP in ALC was 16.2% (95% CI 10.4–24.5) overall, and 15.5% (95% CI 8.0–27.7) when data were limited to clinical studies. Corresponding prevalence for ALC in ACP was 21.5% (95% CI 12.0–35.6) and 16.9% (95% CI 11.5–24.3), respectively. There was significant heterogeneity among studies (I2 – 65–92%). Pooled prevalence for ALP in ALD or ALD in ALP in clinical studies were 15.2% and 39%, respectively. None of the studies reported outcomes in patients with coexistent disease.ConclusionA sizeable fraction of patients with ACP or ALC have coexistent disease. Future studies should define the prevalence of coexistent disease in women and minority populations, and the consequences of coexistent disease on clinical presentation and short- and long-term outcomes. |
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