Natural history,clinical characteristics,outcomes,and long-term follow-up of pain-free chronic pancreatitis

作     者：Awais Ahmed Ishani Shah Rachel Bocchino Steven D.Freedman Darshan J.Kothari Sunil G.Sheth 

作者机构：Department of MedicineDivision of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Department of MedicineDivision of Internal MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Department of MedicineDivision of GastroenterologyDuke UniversityDurhamNCUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2023年第11卷第1期

页      面：309-315页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：chronic pancreatitis pain-free pancreatic insufficiency diabetes 

摘      要：Background:Chronic pancreatitis(CP)is characterized by chronic abdominal pain and functional ***,a small subset of patients with prior acute pancreatitis(AP)and/or underlying risk factors for developing CP may be pain-free at diagnosis and may have a different clinical *** aimed to compare the clinical characteristics,outcomes,and healthcare utilization between CP patients with and without ***:Reviewed patients with established CP were followed in our Pancreas Center between January 2016 and April *** without risk factors for developing CP and/or without AP prior to their diagnosis and only with incidental radiologic features of CP were excluded,so as tominimize confounding factors of pancreatopathy unrelated to *** were divided into painful and pain-free groups to analyze differences in demographics,outcomes,and healthcare ***:Of 368 CP patients,49(13.3%)were pain-free at diagnosis and had remained so for9 *** were no significant differences in body mass index,race,sex,or co-morbidities between the two ***-free patients were older at diagnosis(53.9 vs 45.7,P=0.004)and had less recurrent AP(RAP)(43.8%vs 72.5%,P0.001)and less exocrine pancreatic insufficiency(EPI)(34.7%vs 65.7%,P0.001).Pain-free patients had less disability(2.2%vs 22.0%,P=0.003),mental illness(20.4%vs 61.0%,P0.001),surgery(0.0%vs 15.0%,P=0.059),and therapeutic interventions(0.0%vs 16.4%,P=0.005)for ***:We described a unique subset of patients with underlying risk factors for CP and/or prior AP who were painfree at *** were older at diagnosis,had less EPI and RAP,and overall favorable outcomes with minimal resource utilization.