[Natural history of chronic pancreatitis]

The natural history of alcoholic chronic pancreatitis is well-known. Patients who are the most frequently involved by the disease are 40-50 year old men. About 15,000 patients have chronic pancreatitis in France. The first symptoms occur after 10-20 years of alcohol abuse. Pain is the first symptom in 80% of patients and acute pancreatitis in one third of them. During the 5 first years of the course, pseudocyst or common bile duct compression may occur. Between the 5th-10th years of the course, acute bouts are rare but the risk of pseudocyst and extrahepatic cholestasis remains high. Therefore, patients may still undergo surgery. On the other hand, the proportion of pain free patients increases. After the 10th year of the disease, pancreatic calcifications are frequent and exocrine and endocrine pancreatic insufficiency occurs in the majority of patients.