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Prospective study of early chronic pancreatitis diagnosed based on the Japanese diagnostic criteria

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Chronic pancreatitis (CP) is a fibro-inflammatory disease of the pancreas. Early diagnosis and intervention, before CP becomes established and irreversible, are essential to improve the long-term outcomes. The world’s first diagnostic criteria for early CP were proposed in Japan in 2009, but their clinical utility remains elusive. This study aimed to clarify whether patients with early CP progress to definite CP.

Methods

This is a multicenter, prospective study. Patients diagnosed as having early CP according to the Japanese diagnostic criteria were prospectively followed for 2 years. Clinical profiles including symptoms, drinking and smoking status, laboratory data, imaging findings and treatments were analyzed.

Results

Among the 83 patients who completed the 2-year follow-up period, four (4.8%) patients progressed to definite CP. The diagnosis of 48 (57.8%) patients was unchanged, and that of 31 (37.3%) patients was downgraded. All the four progressive patients were male, alcohol-related, smokers (3 current and 1 ever), and continued drinking. Comparison of the clinical profiles between the progression group (n = 4) and non-progression group (n = 79) revealed that etiology (alcohol-related), smoking status and presence of acute pancreatitis episodes were associated with the progression to definite CP.

Conclusions

The Japanese diagnostic criteria could identify some patients before the progression to definite CP, while the majority of the patients did not progress. Trial registration number: UMIN000015992.

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Abbreviations

AP:

Acute pancreatitis

BT-PABA:

N-benzoyl-l-tyros-p-amino benzoic acid

CP:

Chronic pancreatitis

CT:

Computed tomography

DCECP:

Diagnostic criteria for early chronic pancreatitis

EUS:

Endoscopic ultrasonography

MRCP:

Magnetic resonance cholangiopancreatography

SD:

Standard deviation

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Acknowledgements

This work was supported in part by the Japan Pancreas Society. The authors are grateful to the members of the Committee of Clinical Research, the Japan Pancreas Society for helpful discussion.

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Authors and Affiliations

  1. Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Atsushi Masamune, Tatsuhide Nabeshima, Kazuhiro Kikuta, Shin Hamada, Eriko Nakano, Kiyoshi Kume, Atsushi Kanno & Tooru Shimosegawa

  2. Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan

    Ai Sato & Atsushi Irisawa

  3. Department of Gastroenterology, Dokkyo Medical University School of Medicine, Mibu, Japan

    Ai Sato & Atsushi Irisawa

  4. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yuichi Tachibana & Tetsuhide Ito

  5. Department of Medicine, Shiga University of Medical Science, Otsu, Japan

    Osamu Inatomi & Akira Andoh

  6. Department of Gastroenterology, Bantane Hospital, Fujita Health University, Nagoya, Japan

    Satoshi Yamamoto & Kazuo Inui

  7. Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan

    Tsukasa Ikeura & Kazuichi Okazaki

  8. Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan

    Seiji Futagami

  9. Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

    Masashi Taguchi

  10. Department of Gastroenterology, JA Onomichi General Hospital, Onomichi, Japan

    Keiji Hanada

  11. Department of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan

    Kyoko Shimizu

  12. Department of Gastroenterology, Fujieda Municipal Hospital, Fujieda, Japan

    Masanobu Kageoka

  13. Department of Gastroenterology, University of Tokyo, Tokyo, Japan

    Tomotaka Saito

  14. Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan

    Takaaki Eguchi

  15. Department of Endoscopy, Yokohama City University Hospital, Yokohama, Japan

    Kensuke Kubota

  16. Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan

    Mamoru Takenaka

  17. Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Atsushi Mima

  18. Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan

    Yoshifumi Takeyama

  19. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan

    Hiroki Yamaue

Authors
  1. Atsushi Masamune
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  2. Tatsuhide Nabeshima
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  3. Kazuhiro Kikuta
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  4. Shin Hamada
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  5. Eriko Nakano
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  6. Kiyoshi Kume
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  7. Atsushi Kanno
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  8. Ai Sato
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  9. Yuichi Tachibana
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  10. Osamu Inatomi
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  11. Satoshi Yamamoto
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  12. Tsukasa Ikeura
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  13. Seiji Futagami
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  14. Masashi Taguchi
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  15. Keiji Hanada
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  16. Kyoko Shimizu
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  17. Masanobu Kageoka
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  18. Tomotaka Saito
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  19. Takaaki Eguchi
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  20. Kensuke Kubota
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  21. Mamoru Takenaka
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  22. Atsushi Mima
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  23. Atsushi Irisawa
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  24. Tetsuhide Ito
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  25. Akira Andoh
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  26. Kazuo Inui
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  27. Yoshifumi Takeyama
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  28. Hiroki Yamaue
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  29. Kazuichi Okazaki
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  30. Tooru Shimosegawa
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Corresponding author

Correspondence to Atsushi Masamune.

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Masamune, A., Nabeshima, T., Kikuta, K. et al. Prospective study of early chronic pancreatitis diagnosed based on the Japanese diagnostic criteria. J Gastroenterol 54, 928–935 (2019). https://doi.org/10.1007/s00535-019-01602-9

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  • DOI: https://doi.org/10.1007/s00535-019-01602-9

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