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Current Situation and Problems in Diagnosis of Early Chronic Pancreatitis

Koichi Ito1, Yusuke Takasaki, Toshio Fujisawa

  • 1From the Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.

Pancreas
|October 2, 2023
PubMed

Insights

Diagnosing early chronic pancreatitis (ECP) is challenging, with low confirmation rates, especially in nonalcoholic cases. Pancreatic pain cases showed a slightly higher diagnostic rate for ECP.

Area of Science:

  • Gastroenterology
  • Pancreatology
  • Diagnostic Medicine

Background:

  • The concept of early chronic pancreatitis (ECP) was introduced in 2009, but its epidemiological characteristics and diagnostic challenges remain largely unaddressed.
  • Understanding the diagnostic landscape of ECP is crucial for timely intervention and management.

Purpose of the Study:

  • This study aimed to investigate the diagnostic challenges and confirm the diagnostic rate of early chronic pancreatitis (ECP) using established criteria.
  • The research sought to evaluate the effectiveness of current diagnostic criteria in identifying ECP across different patient cohorts.

Main Methods:

  • A total of 2502 cases were analyzed between April 2019 and November 2021.
  • Early chronic pancreatitis (ECP) diagnosis was performed on 4 distinct cohorts using the Clinical Diagnostic Criteria for Chronic Pancreatitis 2019, including patients with abdominal pain, abnormal pancreatic enzymes, suspected ECP, and those undergoing endoscopic ultrasonography.
  • Endoscopic ultrasonography was utilized to assess ECP findings in 150 selected cases.

Main Results:

  • Out of 150 cases with suspected ECP findings on endoscopic ultrasonography, only 14 (9.3%) were confirmed.
  • The confirmation rate for ECP was 22.5% in alcoholic cases and 4.5% in nonalcoholic cases.
  • The diagnostic yield varied significantly across the four cohorts, ranging from 15% to 0.13%, with the highest rate observed in the abdominal/back pain cohort (48% of those with pain).

Conclusions:

  • The overall diagnostic rate for early chronic pancreatitis (ECP) was low, particularly in nonalcoholic individuals.
  • ECP diagnosis was slightly more successful in patients presenting with pancreatic pain.
  • Further research is necessary to refine and establish more effective diagnostic criteria for early chronic pancreatitis (ECP).
Abstract

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