Related Experiment Video
Updated: Feb 13, 2026
Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: December 14, 2019
Long-term disease progression in pediatric acute recurrent and chronic pancreatitis: A report from INSPPIRE
Elissa M Downs1, Emily R Perito2, Fuchenchu Wang3
1University of Minnesota, United States.
Insights
Nearly 1 in 5 children with acute recurrent pancreatitis (ARP) progressed to chronic pancreatitis (CP). Risk factors for progression to CP include genetics and frequent acute pancreatitis episodes.
Area of Science:
- Pediatric Gastroenterology
- Pancreatology
Background:
- Childhood acute recurrent pancreatitis (ARP) can lead to chronic pancreatitis (CP).
- The INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE) cohort offers insights into disease progression.
Purpose of the Study:
- To analyze the progression of ARP to CP in children.
- To identify risk factors and sequelae associated with pancreatitis progression in a pediatric cohort.
Main Methods:
- Categorized 626 children into persistent ARP (pARP), incident CP (iCP), or prevalent CP (pCP).
- Analyzed time-to-sequelae and risk factors for progression using prospectively collected data.
Main Results:
- 21.1% of ARP cases progressed to iCP.
- Incident CP cases were more likely to have PRSS1 mutations, obstructive factors, and more acute pancreatitis episodes.
- Exocrine pancreatic insufficiency (EPI) developed in 24% of children during follow-up; 32% of iCP cases developed EPI.
- Diabetes mellitus (DM) developed in 8% during follow-up.
Conclusions:
- Nearly one in five children with ARP progressed to CP.
- Genetics, obstructive disease, and high episode frequency are risk factors for progression.
- A subset of children developed irreversible sequelae such as EPI and DM.
Background:
Acute recurrent pancreatitis (ARP) in childhood can rapidly progress to chronic pancreatitis (CP). Prospectively-collected data from the INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE) provides novel insight into disease progression.
Methods:
INSPPIRE subjects were categorized as persistent ARP (pARP = remained ARP through last follow-up), incident CP (iCP = ARP at enrollment, developed CP), or prevalent CP (pCP = CP at enrollment). Time-to-sequelae and risk factors were analyzed.
Results:
Of 626 total children, 384 (61%) were ARP at baseline; of these, 81 (21.1%) were iCP at follow-up. iCP were more likely to have PRSS1 mutations, obstructive risk factors, and more acute pancreatitis episodes (AP) vs. pARP, but didn't differ in age at first AP. Exocrine pancreatic insufficiency (EPI) developed in 24% during follow-up, 10% of pARP, 32% of iCP. In all CP, 50% had EPI by 17.7yrs, median 10yrs after first AP. Diabetes mellitus (DM) developed in 8% during follow-up, 6% of pARP, 5% of iCP. In all CP, median event-free survival from birth and after first AP was not reached.
Conclusions:
Prospective follow-up of children with ARP revealed nearly 1 in 5 progressed to CP, with a subset developing irreversible sequelae, and highlighted risk factors associated with progression including genetics, obstructive disease, and episode frequency.
Related Concept Videos
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:25Chronic Kidney Disease I: Introduction