Impact of etiology on disease course in chronic pancreatitis |
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| Affiliation: | 1. Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany;2. Department of Gastroenterology, University Hospital Gießen, Rudolf-Buchheim-Straße 8, 35392, Gießen, Germany;3. Department of Gastroenterology, University Hospital Donetsk, Ukraine, Illicha Ave 16, 83000, Donetsk, Ukraine;4. Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany;5. Department of Gastroenterology and Hepatology, Medical Center Bad Hersfeld, Seilerweg 29, 36251, Bad Hersfeld, Germany;1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States;2. Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Lucile Packard Children''s Hospital at Stanford, Stanford, CA 94305, United States;1. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women''s Hospital, Boston, MA, USA;2. Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women''s Hospital, Boston, MA, USA;3. Dover Corporation, Watertown, MA, USA;1. Gastroenterology Clinic, Adnan Menderes Bulvarı, Vatan Cad, 34093, Fatih, Istanbul, Turkey;2. Istanbul Medipol University, School of Business and Management Sciences, Kavacık Campus, Istanbul, Turkey;3. Internal Medicine Clinic, Medicana International Hospital, Beylikdüzü Cd. No:3, 34520, Beylikdüzü, Istanbul, Turkey;1. Department of Internal Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA;2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA;1. Université de Reims Champagne-Ardenne, Department of Digestive Oncology, CHU Reims, Reims, France;2. Department of Medical Oncology, Poitiers University Hospital, Poitiers, France;3. Department of Medical Oncology, Godinot Cancer Institute, Reims, France;4. Department of Hepato-Gastro-enterology, Poitiers University Hospital, Poitiers, France;5. Department of Digestive and Oncological Surgery, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France;6. Department of Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France;7. Department of Medical Oncology, CHU Lille, University of Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020 - UMR-S 1277, Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Lille, France;8. Department of Hepatogastroenterology, CHU Saint Etienne, Saint-Priest-en-Jarez, France |
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| Abstract: | BackgroundComplications in chronic pancreatitis (CP) can be grouped in inflammatory (ICC) and fibrotic (FCC) clusters and pancreatic insufficiency cluster (PIC). However, the association between etiological risk factors and the development of complication clusters remains obscure. In this study, the impact of the etiology and disease duration on disease onset and development of complications was investigated.MethodsThis cross-sectional study recruited patients with CP from Mannheim/Germany (n = 870), Gieβen/Germany (n = 100) und Donetsk/Ukraine (n = 104). Etiological risk factors, disease stage, age at disease onset, complications, need for hospitalization and surgery were noted.ResultsIn 1074 patients diagnosed with CP, main risk factors were alcohol and nicotine abuse. An earlier onset of the disease was observed upon nicotine abuse (−4.0 years). Alcohol abuse was only associated with an earlier onset of the definite stage of CP.Alcohol abuse was the major risk factor for the development of ICC (p < 0.0001, multiple regression modeling). Abstinence of alcohol reduced ICC, whereas abstinence of nicotine showed no association. PIC correlated with efferent duct abnormalities and the disease duration. In contrast, FCC was mainly dependent on the disease duration (p < 0.0001; t-test). The presence of any complication cluster correlated with the need for surgery (p < 0.01; X2-test). However, only ICC correlated with a prolonged hospital stay (p < 0.05; t-test).ConclusionsICC is mainly dependent on alcohol abuse. In contrast, FCC and PIC are mainly dependent on the disease duration. The etiology and disease duration can be used as predictors of the course of disease to provide individual treatment and surveillance strategies. |
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| Keywords: | Chronic pancreatitis Complication cluster Etiology CP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" (chronic pancreatitis) ICC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" (inflammatory complication cluster) FCC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" (fibrotic complication cluster) PIC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" (pancreatic insufficiency cluster) LTDH" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" (life-time drinking history) |
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