Skip to main content
SpringerLink
Log in

The revised Japanese clinical diagnostic criteria for chronic pancreatitis

  • Review
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

In Japan, we are now using the clinical diagnostic criteria for chronic pancreatitis (CP) that were revised in 2001 to add the findings of magnetic resonance cholangiopancreatography to the criteria compiled by the Japan Pancreas Society (JPS) in 1995. Because the current criteria are set for diagnosing advanced CP, they are unlikely to improve patients’ prognoses. In addition, they seem unsuitable for current clinical practice because exocrine pancreatic function tests, which have become obsolete in Japan, are included in the diagnostic factors. For these reasons, the Research Committee on Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan, the JPS and the Japanese Society of Gastroenterology have revised the criteria. The revised criteria are unique in that they contain an introduction to the concept of early CP. It is a challenge aimed at improvement of the long-term prognosis of CP patients by early diagnosis and therapeutic intervention in this disease. We need to determine and clarify the clinico-pathological outcome of early CP by a prospective long-term follow-up of the patients in this category.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sarles H (ed). Pancreatitis symposium of Marseille, 1963. Karger: Basel;1965.

  2. Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984;25:756–9.

    Article  CAS  PubMed  Google Scholar 

  3. Singer MV, Gyr K. Revised classification of pancreatitis. Report of the second international symposium on the classification of pancreatitis in Marseille, France, March 28–30, 1984. Gastroenterology. 1985;89:683–90.

  4. Sarles H, Adler G, Dani R, Frey C, Gullo L, Harada H, et al. The pancreatitis classification of Marseilles–Rome. Digestion. 1989;43:234–6.

    Article  CAS  PubMed  Google Scholar 

  5. Chari ST, Singer MV. The problem of classification and staging of chronic pancreatitis: proposals based on current knowledge of its natural history. Scand J Gastroenterol. 1994;29:949–60.

    Article  CAS  PubMed  Google Scholar 

  6. Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis: summary of an international workshop on chronic pancreatitis. Pancreas. 1997;14:215–21.

    Article  CAS  PubMed  Google Scholar 

  7. Homma T, Harada H, Koizumi M. Diagnostic criteria for chronic pancreatitis by the Japan Pancreas Society. Pancreas. 1997;15:14–5.

    Article  CAS  PubMed  Google Scholar 

  8. Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification and new genetic developments. Gastroenterology. 2001;120:682–707.

    Article  CAS  PubMed  Google Scholar 

  9. Ramesh H. Proposal for a new grading system for chronic pancreatitis: the ABC system. J Clin Gastroenterol. 2002;35:67–70.

    Article  CAS  PubMed  Google Scholar 

  10. Uomo G. How far are we from the most accurate classification system for chronic pancreatitis? J Pancreas. 2002;3:62–5.

    Google Scholar 

  11. The Japanese Society of Pancreatic Disease. Clinical diagnostic criteria for chronic pancreatitis (in Japanese). Jpn J Gastroenterol. 1971;68(11):i–ii.

    Google Scholar 

  12. The Criteria Committee for Chronic Pancreatitis of the Japanese Society of Gastroenterology. Clinical diagnostic criteria of chronic pancreatitis (in Japanese). Jpn J Gastroenterol. 1983;80:1863–6.

    Google Scholar 

  13. The Criteria Committee for Chronic Pancreatitis of the Japan Pancreas Society. Final report of clinical diagnostic criteria of chronic pancreatitis (in Japanese). J Jpn Pancreas Soc (Suizo). 1995;10(4):xxiii–xxvi.

    Google Scholar 

  14. The Criteria Committee for Chronic Pancreatitis of the Japan Pancreas Society. JPS clinical diagnostic criteria of chronic pancreatitis 2001 (in Japanese). J Jpn Pancreas Soc (Suizo). 2001;16(6):560–1.

    Google Scholar 

  15. Koizumi M, Otsuki M, Saisho H, Naruse S, Hirota M, Nagai H et al. The clinical features of early chronic pancreatitis (in Japanese). The 2002 Annual report of the Research Committee of the Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan (RCIPD). 2003, pp 113–5.

  16. Koizumi M, Otsuki M, Saisho H, Hirota M, Sawabu N, Suga T et al. Usefulness of EUS in the diagnosis of chronic pancreatitis (in Japanese). The 2002 Annual report of the Research Committee of the Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan (RCIPD). 2003, pp 116–8.

  17. Nagai H, Sata N, Inui K, Ochi K, Kataoka K, Kamisawa T et al. Re-evaluation of diagnostic criteria of chronic pancreatitis (iii): a proposal of new diagnostic criteria for alcoholic pancreatic injury (in Japanese). The 2003 Annual report of the Research Committee of the Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan (RCIPD). 2004, pp 128–30.

  18. Koizumi M, Otsuki M, Ito T, Inui K, Irisawa A, Ohara H et al. The diagnostic criteria for early chronic pancreatitis and the guidelines for therapy (in Japanese). The 2007 Annual report of the Research Committee of the Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan (RCIPD). 2008, pp 75–9.

  19. Sata N, Otsuki M, Koizumi M, Maruyama K. The initial findings of alcoholic pancreatic injury (in Japanese). The 2007 Annual report of the Research Committee of the Intractable Pancreatic Diseases supported by the Ministry of Health, Labour and Welfare of Japan (RCIPD). 2008, pp 80–5.

  20. Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69:1251–61.

    Article  PubMed  Google Scholar 

  21. Wiersema MJ, Hawes RH, Lehman GA, Kochman ML, Sherman S, Kopecky KK. Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy. 1993;25:555–64.

    Article  CAS  PubMed  Google Scholar 

  22. Hawes RH, Zaidi S. Endoscopic ultrasonography of the pancreas. Gastrointest Endosc Clin North Am. 1995;5:61–80.

    CAS  Google Scholar 

  23. Wirsema MJ, Wiersema LM. Endosonography of the pancreas: normal variation versus changes of early chronic pancreatitis. Gastrointest Endosc Clin North Am. 1995;5:487–96.

    Google Scholar 

  24. Mariani A, Testoni PA. Is acute recurrent pancreatitis a chronic disease? World J Gastroenterol. 2008;21:995–8.

    Article  Google Scholar 

  25. Forsmark CE. The early diagnosis of chronic pancreatitis. Clin Gastroenterol Hepatol. 2008;6:1291–3.

    Article  PubMed  Google Scholar 

  26. DeWitt J, McGreevy K, LeBlanc J, McHenry L, Cummings O, Sherman S. EUS-guided Trucut biopsy of suspected nonfocal chronic pancreatitis. Gastrointest Endosc. 2005;62:76–84.

    Article  PubMed  Google Scholar 

  27. Conwell DL, Zuccaro G Jr, Vargo JJ, Trolli PA, VanLente F, Obuchowski N, et al. An endoscopic pancreatic function test with synthetic porcine secretin for the evaluation of chronic abdominal pain and suspected chronic pancreatitis. Gastrointest Endosc. 2003;57:37–40.

    Article  PubMed  Google Scholar 

  28. Parsi MA, Conwell DL, Zuccaro G, Stevens T, Lopez R, Dumot JA, et al. Findings on endoscopic retrograde cholangiopancreatography and pancreatic function test in suspected chronic pancreatitis and negative cross-sectional imaging. Clin Gastroenterol Hepatol. 2008;6:1432–6.

    Article  PubMed  Google Scholar 

  29. Czako L. Diagnosis of early-stage chronic pancreatitis by secretin-enhanced magnetic resonance cholangiopancreatography. J Gastroenterol. 2007; 42 Suppl 27:113–7.

    Google Scholar 

  30. Ishii Y, Kohno T, Ito A, Suzuki S, Kohno T, Takayama Y, et al. Measurement of extra-pancreatic secretory function by 13C-dipeptide breath test. Transl Res. 2007;149:298–303.

    Article  CAS  PubMed  Google Scholar 

  31. Otsuki M, Nishimori I, Hayakawa T, Hirota M, Ogawa M, Shimosegawa T. The Research Committee on Intractable Disease of the Pancreas. Hereditary pancreatitis: clinical characteristics and diagnostic criteria in Japan. Pancreas. 2004;28:200–6.

    Article  PubMed  Google Scholar 

  32. Kamisawa T, Yoshiike M, Egawa N, Nakajima H, Tsuruta K, Okamoto A. Treating patients with autoimmune pancreatitis: results from a long-term follow-up study. Pancreatology. 2005;5:234–8.

    Article  PubMed  Google Scholar 

  33. Nishino T, Toki F, Oyama H, Shimizu K, Shiratori K. Long-term outcome of autoimmune pancreatitis after oral prednisolone therapy. Intern Med. 2006;45:497–501.

    Article  PubMed  Google Scholar 

  34. Takayama M, Hamano H, Ochi Y, Saegusa H, Komatsu K, Muraki T, et al. Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation. Am J Gastroenterol. 2004;99:932–7.

    Article  PubMed  Google Scholar 

  35. Members of the Criteria Committee for Autoimmune Pancreatitis of the Japan Pancreas Society. Diagnostic criteria for autoimmune pancreatitis by the Japan Pancreas Society. J Jpn Pancreas (Suizou) 2002;17:587.

    Google Scholar 

  36. Okazaki K, Kawa S, Kamisawa T, Naruse S, Tanaka S, Nishimori I, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.

    Article  PubMed  Google Scholar 

  37. Choi EK, Kim M-H, Kim JC, Han J, Seo DW, Lee SS, et al. The Japanese diagnostic criteria for autoimmune chronic pancreatitis: is it completely satisfactory? Pancreas. 2006;33:13–9.

    Article  PubMed  Google Scholar 

  38. Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006;4:1010–6.

    Article  PubMed  Google Scholar 

  39. Otsuki M, Chung JB, Okazaki K, Kim M-H, Kamisawa T, Kawa S, et al. The Research Committee of Intractable Pancreatic Diseases provided by the Ministry of Health, Labour and Welfare of Japan and the Korean Society of Pancreatobiliary Diseases. J Gastroenterol. 2008;43:403–8.

    Article  CAS  PubMed  Google Scholar 

  40. Steer ML. Classification and pathogenesis of pancreatitis. Surg Clin North Am. 1989;69:467–80.

    CAS  PubMed  Google Scholar 

  41. Axon AT, Olassen M, Cotton PB, Cremer M, Freeny PC, Lees WR. Pancreatography in chronic pancreatitis: international definitions. Gut. 1984;25:1107–12.

    Article  CAS  PubMed  Google Scholar 

  42. Kahl S, Glasbrenner B, Leodolter A, Pross M, Schulz H-U, Malfertheiner P. EUS in the diagnosis of early chronic pancreatitis: a prospective follow-up study. Gastrointest Endosc. 2002;55:507–11.

    Article  PubMed  Google Scholar 

  43. Catalano MF, Lahoti S, Geenen JE, Hogan WJ. Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis. Gastrointest Endosc. 1998;48:11–7.

    Article  CAS  PubMed  Google Scholar 

  44. Sahai AV, Zimmerman M, Aabakken L, Tarnasky PR, Cunningham JT, van Verse A, et al. Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography. Gastrointest Endosc. 1998;48:18–25.

    Article  CAS  PubMed  Google Scholar 

  45. Raimondo M, Wallace MB. Diagnosis of early chronic pancreatitis by endoscopic ultrasound. Are we there yet? J Pancreas. 2004;5:1–7.

    Google Scholar 

  46. Chong AKH, Hawes RH, Hoffman BJ, Adams DB, Lewin DN, Romagnuolo J. Diagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology. Gastrointest Endosc. 2007;65:808–14.

    Article  PubMed  Google Scholar 

  47. Gleeson FC, Topazian M. Endoscopic retrograde chlangiopancreatography and endoscopic ultrasound for diagnosis of chronic pancreatitis. Curr Gastroenterol Rep. 2007;9:123–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by a Grant-in-Aid to the Research Committee on Intractable Pancreatic Diseases (Chairman, Tooru Shimosegawa), provided from the Ministry of Health, Labour and Welfare of Japan.

Author information

Authors and Affiliations

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

    Tooru Shimosegawa & Morihisa Hirota

  2. Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan

    Keisho Kataoka

  3. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Terumi Kamisawa

  4. Department of Internal Medicine, Sapporo-Kosei General Hospital, Sapporo, Japan

    Hiroyuki Miyakawa

  5. Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Hirotaka Ohara

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

    Tetsuhide Ito

  7. Department of Internal Medicine, Miyoshi Municipal Hospital, Miyoshi, Japan

    Satoru Naruse

  8. Department of Surgery, Jichi Medical University, Shimotsuke, Japan

    Naohiro Sata

  9. Department of Pathology, Tokyo-Nishi Tokushukai Hospital, Tokyo, Japan

    Koichi Suda

  10. Department of Surgery, Kinki University School of Medicine, Osaka-Sayama, Japan

    Yoshifumi Takeyama

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

    Keiko Shiratori

  12. Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan

    Takashi Hatori

  13. Department of Nutrition and Lifestyle-Related Diseases, Graduate School of Life Science, Kobe Women’s University, Kobe, Japan

    Makoto Otsuki

  14. Department of Surgery, Kyorin University, Mitaka, Japan

    Yutaka Atomi

  15. Department of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

    Kentaro Sugano

  16. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Masao Tanaka

Authors
  1. Tooru Shimosegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keisho Kataoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Terumi Kamisawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Miyakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hirotaka Ohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tetsuhide Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Satoru Naruse
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Naohiro Sata
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Koichi Suda
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Morihisa Hirota
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yoshifumi Takeyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Keiko Shiratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Takashi Hatori
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Makoto Otsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yutaka Atomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Kentaro Sugano
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Masao Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tooru Shimosegawa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shimosegawa, T., Kataoka, K., Kamisawa, T. et al. The revised Japanese clinical diagnostic criteria for chronic pancreatitis. J Gastroenterol 45, 584–591 (2010). https://doi.org/10.1007/s00535-010-0242-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-010-0242-4

Keywords

Search

Navigation