| Chronic pancreatitis. Long-term pain relief with or without surgery, cancer risk, and mortality. | |
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MedLine Citation:
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PMID: 12544201 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To determine the natural history of chronic pancreatitis (CP), we retrospectively studied 193 consecutive patients who had at least one hospitalization for the control of pain or a complication of CP by examining the hospital records and by using a standard questionnaire. Alcohol (66%) was the major cause of CP and the cause was unknown in 21%. Pain was the presenting symptom in 93%. Pancreatic calcification was observed in 41% (alcoholic 54% vs. nonalcoholic 19%; OR = 6.7, CI = 2.7, 14.3; p < 0.0001). Diabetes (28%), malabsorption (16%), pseudocysts (21%) and pancreatic (3%) or extrapancreatic malignancy (5%) were the main complications. 43% had surgical intervention for pain relief, 10% had either endoscopic sphincterotomy or surgical sphincteroplasty and 16% had surgery for complications. Surgical or endoscopic intervention was more commonly performed in nonalcoholics compared with alcoholics (OR = 12.8, CI = 3.6, 53.9; p < 0.0001). However, if sphincterotomy and sphincteroplasty were excluded, the total number of surgical procedures for pain relief was similar in both groups. Complete follow-up information was available in 107 patients with a mean duration of follow-up of 10 years (range, 1-28 years); 27 patients died during the follow-up; 5, 10 and 15 year mortality was 14%, 18% and 20% respectively. The mortality was significantly higher in patients with alcoholic CP than in nonalcoholic CP (35% vs. 10%; OR = 1.4, 18.7; p = 0.005). Of the 80 patients who were alive and had complete long-term follow-up, pain improved in 62 patients, remained unchanged in 17 and worsened in one. Pain improved in 34 of 41 (83%) patients who had surgical intervention for pain, 7 of 9 patients (78%) who had surgery for complications, 4 of 7 (57%) who had sphincter ablation and 17 of 23 patients (74%) who had nonprocedural treatment. Long-term pain relief was similar in patients with alcoholic and nonalcoholic pancreatitis. |
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Authors:
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Paul J Thuluvath; Dennis Imperio; Satheesh Nair; John L Cameron |
Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 36 ISSN: 0192-0790 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-01-24 Completed Date: 2003-05-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 159-65 Citation Subset: IM |
Affiliation:
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Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. pjthuluv@jhmi.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Digestive System Surgical Procedures* Humans Pain / epidemiology, therapy* Pancreatic Neoplasms / epidemiology, therapy* Pancreatitis / complications*, epidemiology, surgery* Risk Factors Survival Analysis |
| Comments/Corrections | |
Comment In:
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J Clin Gastroenterol. 2003 Feb;36(2):98-9
[PMID:
12544189
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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