scholarly journals Endoscopic Ultrasonography Findings of Early and Suspected Early Chronic Pancreatitis

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1018
Author(s):  
Yusuke Takasaki ◽  
Shigeto Ishii ◽  
Toshio Fujisawa ◽  
Mako Ushio ◽  
Sho Takahashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Endoscopic Ultrasonography ◽  
Progressive Disease ◽  
Morphological Changes ◽  
Pancreatic Ducts ◽  
International Consensus ◽  
Endocrine Insufficiency ◽  
Endoscopic Cholangiopancreatography ◽  
International Consensus Guidelines ◽  
End Stage

Chronic pancreatitis (CP) is associated with a risk of pancreatic cancer and is characterized by irreversible morphological changes, fibrosis, calcification, and exocrine and endocrine insufficiency. CP is a progressive disease with a poor prognosis and is typically diagnosed at an advanced stage. The Japan Pancreas Society proposed criteria for early CP in 2009, and their usefulness has been reported. Recently, a mechanism definition was proposed by the International Consensus Guidelines and early CP was defined as a disease state that is not based on disease duration. CP is diagnosed by computed tomography, magnetic resonance imaging, and endoscopic cholangiopancreatography, which can detect calcification and dilation of the pancreatic ducts; however, detecting early CP with these modalities is difficult because subtle changes in early CP occur before established CP or end-stage CP. Endoscopic ultrasonography (EUS) is useful in the diagnosis of early CP because it allows high-resolution, close-up observation of the pancreas. In addition to imaging findings, EUS with elastography enables measurement of the stiffness of the pancreas, an objective diagnostic measure. Understanding the EUS findings of early CP is important because a histological diagnosis is problematic, and other modalities are not capable of detecting subtle changes in early CP.

scholarly journals Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Péter J. Hegyi ◽  
Alexandra Soós ◽  
Emese Tóth ◽  
Attila Ébert ◽  
Viktória Venglovecz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Morphological Changes ◽  
International Study ◽  
Study Data ◽  
Cross Sectional ◽  
Clinical Biomarkers ◽  
Stage Disease ◽  
Significant Difference ◽  
End Stage

AbstractChronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

scholarly journals Elevated Levels of Alpha Cells Emanating from the Pancreatic Ducts of a Patient with a Low BMI and Chronic Pancreatitis

2018 ◽  
Vol 27 (6) ◽  
pp. 902-906 ◽  
Author(s):  
M’Balu A. Webb ◽  
Jane J. Chen ◽  
Roger F. L. James ◽  
Melanie J. Davies ◽  
Ashley R. Dennison
Keyword(s):  
Chronic Pancreatitis ◽  
Cross Sections ◽  
Morphological Changes ◽  
Future Research ◽  
Pancreatic Ducts ◽  
Intractable Pain ◽  
Recurrent Acute Pancreatitis ◽  
Partial Pancreatectomy ◽  
Striking Change ◽  
Cell Genesis

Chronic pancreatitis (CP) is an inflammatory disease that causes progressive damage to the pancreatic parenchyma with irreversible morphological changes and fibrotic replacement of the gland. The risk factors associated with developing CP have been described as toxic (e.g., alcohol and tobacco); idiopathic (e.g., unknown); genetic, autoimmune, recurrent acute pancreatitis, and obstructive (the TIGAR-O system). Upon histological screening of the pancreata from a cohort of CP patients who had undergone pancreatectomy for the treatment of intractable pain in Leicester, UK, one sample showed a striking change in the morphological balance toward an endocrine phenotype, most notably there was evidence of substantial α cell genesis enveloping entire cross sections of ductal epithelium and the presence of α cells within the ductal lumens. This patient had previously undergone a partial pancreatectomy, had severe sclerosing CP, an exceptionally low body mass index (15.2), and diabetes at the time the pancreas was removed, and although these factors have been shown to induce tissue remodeling, such high levels of α cells was an unusual finding within our series of patients. Due to the fact that α cells have been shown to be the first endocrine cell type that emerges during islet neogenesis, future research profiling the factors that caused such marked α cell genesis may prove useful in the field of islet transplantation.

International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis

Pancreatology ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 149-157 ◽  
Author(s):  
M.A. Kempeneers ◽  
Y. Issa ◽  
U. Ahmed Ali ◽  
R.D. Baron ◽  
M.G. Besselink ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Consensus Guidelines ◽  
International Consensus ◽  
International Consensus Guidelines
Sign in / Sign up

Export Citation Format

Share Document