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Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

World Journal of Gastroenterology 2008年第40期14卷 6171-6179页

作者： Luis Aparisi Luis Sabater Juan Del-Olmo Juan Sastre Miguel-Angel Serra Ricardo Campello Daniel Bautista abdalla wassel José-Manuel Rodrigo Liver Unit Universitary Clinic Hospital Department of Surgery Universitary Clinic Hospital Department of Physiology University of Valencia Unit of Psiquiatry Servicio Valenciano de SaludValencia 46010Spain Department of Preventive Medicine Hospital Dr.Peset

AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology,after excluding any other causes.METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53),LC (n = 57),and asymptomatic alcoholic (n = 30).Clinical,biochemical and morphological characteristics,Child-Pugh index,indocyanine green test,and fecal pancreatic elastase-1 test were assessed.RESULTS: In patients with cirrhosis,major clinical manifestations of CP such as pancreatic pain and steatorrhea,as well as imaging alterations of CP such as calcifications,duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases,and elastase-1 test was altered in only 7%,and severely altered in none.In patients with CP,clinical characteristics of cirrhosis such as ascites,encephalopathy and gastrointestinal hemorrhage were present in one case,Child-Pugh grade > A in 5.7%,and altered indocyanine green test in 1.9% cases.In asymptomatic alcoholism,there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%,respectively,but other characteristics of cirrhosis or CP were absent.An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients.CONCLUSION: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology,but an inverse correlation between pancreatic and liver function tests.These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

关键词：慢性胰腺炎酒精肝硬化酒精中毒胰腺功能肝功能

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