Clinical features of 307 cases of chronic pancreatitis in China based on the M-ANNHEIM classification system

( views:441, downloads:0 )
Author:
LAI Xiao-wei(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
WANG Xin-tao(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
LIAO Zhuan(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
YE Zhou(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
LI Zhao-shen(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 10, Issue 03, 2010
DOI:
10.3760/cma.j.issn.1674-1935.2010.03.001
Key Word:
Pancreatitis, chronic;The M-ANNHEIM classification;Risk factors;Etiology

Abstract: Objective To investigate the clinical manifestations, etiology and risk factors of chronic pancreatitis guided by the M-ANNHEIM classification of chronic pancreatitis and to evaluate the validity and clinical significance of this classification. Methods A review of clinical data of inpatients in our hospital from December 2007 to December 2009 was conducted. The classification was carried out according to the pancreatitis were enrolled. There were 256 adult patients and 51 children and adolescent patients (age of onset<18 yr). Among these cases, 129(42%) reported a drinking history. 110 cases (35.8%) had a smoking history, 31 cases (10.1%) presented with hyperlipoidemia. 12 cases had some factors related to pancreatic duct such as pancreas divisum, pancreas trauma. There were 231 (75.2%) cases with calcification of pancreas, 45 (14.7%) with exocrine insufficiency (steatorrhea), 58 (18.9%) with endocrine dysfunction (diabetes mellitus), 32 (10.4%) underwent pancreatic surgeries, and 39 (12.7%) with pancreatic pseudocysts, biliary obstruction, pancreatic cancer and other severe complications. The M-ANNHEIM clinical staging of chronic pancreatitis was: no case in stage 0, 220(71.7%) cases in stage Ⅰ , 69(22.5%) cases in stage Ⅱ ,12(3.9%) cases in stage Ⅲ and 6 cases in stage Ⅳ. The mean value of the M-ANNHEIM score and severity index was 7.78,69 (22.5%) cases were in the minor level, 174 (56.7%) were in the increased level,62(20.2%) cases were in the advanced level. Conclusions The M-ANNHEIM classification of chronic pancreatitis is a simple, objective, accurate and noninvasive tool in clinical practice. This new classification system will be helpful for investigating the impact and interaction of various risk factors on the course of the disease.

  • [1]Comfort MW,Gambill EE,Baggenstoss AH.Chronic relapsing pancreatitis; an analysis of 27 cases associated with disease of the biliary tract.Gastroenterology,1948,11:1-33.
  • [2]Singer MV,Gyr K,Sarles H.Revised classification of pancreatitis.Report of the Second International Symposium on the Classification of Pancreatitis in Marseille,France,March 28-30,1984.Gastroenterology,1985,89:683-685.
  • [3]Sarner M,Cotton PB.Classification of pancreatitis.Gut,1984,25:756-759.
  • [4]Sarner M,Cotton PB.Definitions of acute and chronic pancreatitis.Clin Gastroenterol,1984,13:865-870.
  • [5]Axon AT,Classen M,Cotton PB,et al.Pancreatography in chronic pancreatitis:international definitions.Gut,1984,25:1107-1112.
  • [6]Ammann RW.A clinically based classification system for alcoholic chronic pancreatitis:summary of an international workshop on chronic pancreatitis.Pancreas,1997,14:215 -221.
  • [7]Etemad B,Whitcomb DC.Chronic pancreatitis:diagnosis,classification,and new genetic developments.Gastroenterology,2001,120:682-707.
  • [8]Schneider A,Lohr JM,Singer MV.The M-ANNHEIM classification of chronic pancreatitis:introduction of a unifying classification system based on a review of previous classifications of the disease.J Gastroenterol,2007,42:101-119.
  • [9]Sarles H,Adler G,Dani R,et al.The pancreatitis classification of Marseilles,Rome 1988.Scand J Gastroenterol,1989,24:641-642.
  • [10]Lankisch PG,Seidensticker F,Otto J,et al.Secretin-pancreozymin test (SPT) and endoscopic retrograde cholangiopancreatography (ERCP):both are necessary for diagnosing or excluding chronic pancreatitis.Pancreas,1996,12:149-152.
  • [11]Homma T,Harada H,Koizumi M.Diagnostic criteria for chronic pancreatitis by the Japan Pancreas Society.Pancreas,1997,15:14-15.
  • [12]Ammann RW,Muellhaupt B.The natural history of pain in alcoholic chronic pancreatitis.Gastroenterology,1999,116:1132-1140.
  • [13]Freiburghaus AU,Redha F,Ammann RW.Does acute pancreatitis progress to chronic pancreatitis? A microvascular pancreatitis model in the rat.Pancreas,1995,11:374-381.
  • [14]Gorry MC,Gabbaizedeh D,Furey W,et al.Mutations in the cationic trypsinogen gene are associated with recurrent acute and chronic pancreatitis.Gastroenterology,1997,113:1063-1068.
  • [15]Seidensticker F,Otto J,Lankisch PG.Recovery of the pancreas after acute pancreatitis is not necessarily complete.Int J Pancreatol,1995,17:225 -229.
  • [16]Ramesh H.Proposal for a new grading system for chronic pancreatitis:the ABC system.J Clin Gastroenterol,2002,35:67-70.
  • [17]Bagul A,Sirivardena AK.Evaluation of the Manchester classification system for chronic pancreatitis.JOP,2006,7:390-396.
  • [18]Wang LW,Li ZS,Li SD,et al.Prevalence and clinical features of chronic pancreatitis in China:a retrospective multicenter analysis over 10 years.Pancreas,2009,38:248-254.
  • [19]Maisonneuve P,Lowenfels AB,M(u)llhaupt B,et al.Cigarette smoking accelerates progression of alcoholic chronic pancreatitis.Gut,2005,54:510-514.
  • [20]Layer P,Yamamoto H,Kalthoff L,et al.The different courses of early and late onset idiopathic and alcoholic chronic pancreatitis.Gastroenterology,1994,107:1481-1487.
  • [21]Ammann RW,Heitz PU,Kl(O)ppel G.Course of alcoholic chronic pancreatitis:a prospective clinicomorphological long-term study.Gastroenterology,1996,111:224-231.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn