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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic retrograde cholangiopancreatography (ERCP) is debated as the gold standard for diagnosing and staging chronic pancreatitis (CP). The Cambridge classification grades CP on ECRP findings from normal (Grade I) to marked (Grade V). Comparison is needed with histopathology, which is considered the true gold standard to set the accuracy of any diagnostic test. A retrospective study included patients with CP who underwent ERCP and histopathology examination after surgical resection between 2001 and 2006. ERCP findings were staged according to the Cambridge classification. Thirty-one patients underwent initial diagnostic ERCP and surgical resection for chronic pancreatitis between 2001 and 2006 (61% women, 39% men). Patients with CP were diagnosed based on ERCP findings and the Cambridge classification as having normal (2 of 31 [6.5%]), equivocal (4 of 31 [13%]), mild (3 of 31 [9.7%]), moderate (15 of 31 [48%]), and marked (7 of 31 [23%]) pancreatitis. Patients experienced a mean of 5.5 ERCPs with pancreatic duct stenting before surgery and demonstrated a mean time of 25 months (range, 6 months to 3 years) between initial diagnosis and surgery. Surgeries for chronic pancreatitis included 13 (42%) subtotal pancreatectomies, 10 (32%) Whipples, and 8 (26%) distal pancreatectomies. The ERCP findings and histopathology reports correlated in 23 (74%) patients, whereas in eight (26%), findings did not correlate. The early disease group's (9 of 31 classified as normal, equivocal, or mild) ERCP findings correlated with histopathology in 6 of 9 patients (67%). Patients classified as moderate and marked had a correlation of 17 of 22 (77%). ERCP demonstrates a high correlation with pathology for assessing the severity of CP using the Cambridge classification grading system. Patients with normal, equivocal, or mild disease still represent a difficult patient subset for surgical decision-making. ERCP findings accurately predict pathology and thus should be used to help formulate the surgical plan.
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PMID:Endoscopic retrograde cholangiopancreatography and histopathology correlation for chronic pancreatitis. 1972 85

The incidence of chronic pancreatitis grows slowly but steadily. At present, alcohol is the most frequent risk factor, although the new forms of so called non-alcoholic chronic pancreatitis, such as genetically induced pancreatitis and its autoimmune variety, are carefully watched. Alcohol consumption continues to be most closely associated with the disease, though it is no more than a risk factor and other aspects, e.g., genetic predisposition, are prerequisite to the disease development. Imaging methods play a fundamental role in diagnosing the disease; non-invasive magnetic resonance and CT, invasive but safe endosonography, and diagnostically rarely used ECRP that, because of its invasive nature, is currently predominantly used for therapeutic purposes. Genetic markers are also exploited, including CFTR mutation, SPINK 1 and PRRS 1 gene, immunoglobulin G4 in the autoimmune form of the disease as well as, alternatively, pancreatic biopsy. Disease symptoms, i.e., pancreatic malabsorption (enzymes with high lipase content) and pancreatic pain are treated conservatively, with paracetamol as the first line therapy for pain followed, if necessary, by so called synaptic analgesics. Alternatively, endoscopic techniques (drainage) or surgery (drainage and resection) are applied. Hereditary and non-hereditary chronic pancreatitis is among the risk factors for pancreatic cancer and thus patients with these diseases should be closely followed up.
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PMID:[Chronic pancreatitis in 2011]. 2216 91