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Chronic pancreatitis: relation between function and morphology.

S Maartense1, M Ledeboer, A A M Masclee

  • 1Department of Gastroenterology-Hepatology, Leiden University Medical Center P.O. Box 9600, 2300 RC Leiden, The Netherlands.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|February 20, 2004
PubMed
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Morphology and exocrine function correlate in alcohol-induced chronic pancreatitis, but not idiopathic cases. Alcoholic pancreatitis patients show distinct presentation and morphology, but similar endocrine function compared to idiopathic pancreatitis.

Area of Science:

  • Gastroenterology
  • Pancreatic Diseases
  • Medical Imaging

Background:

  • Chronic pancreatitis evaluation involves combined exocrine-endocrine function tests.
  • Tests include urinary para amino benzoic acid (PABA) recovery and pancreatic polypeptide secretion.
  • Glucose tolerance tests also assess endocrine function.

Purpose of the Study:

  • To investigate the relationship between morphological changes and exocrine/endocrine function in chronic pancreatitis patients.
  • To compare presentation, function, and morphology between alcohol-induced and idiopathic chronic pancreatitis.

Main Methods:

  • Retrospective analysis of 103 chronic pancreatitis patients (1989-1999).
  • Correlation of morphology (Cambridge score) with exocrine (PABA recovery, pancreatic polypeptide) and endocrine function.

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  • Comparison of patient groups based on etiology (alcohol vs. idiopathic).

    • Main Results:

    • Significant correlation found between PABA recovery and pancreatic polypeptide secretion with morphologic score (r = -0.205, P = 0.037; r = -0.209, P = 0.031).
    • Correlation was present in alcohol-induced pancreatitis but not idiopathic pancreatitis.
    • Pain was a prominent symptom, more frequent and severe in both alcohol-induced and idiopathic chronic pancreatitis.

    Conclusions:

    • Morphology and exocrine function are correlated in alcohol-induced chronic pancreatitis.
    • No significant correlation between morphology and exocrine function in idiopathic chronic pancreatitis.
    • Alcoholic pancreatitis patients exhibit differences in presentation and morphology, but not function, compared to idiopathic cases.