Still going strong . . .

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Well, fellow travelers, here is a study that went out to ten years!

One thing horribly absent from these studies overall are the ages of

those studied. Also, the mortality doe not seem to be/or not be

attributed to pancreatitis itself. Furthermore, in a few studies,

about 2/3's of pancreatitis sufferers are alcohol abusers. This

surprises me a bit as our group does not seem to reflect this type of

a level at all. Well, here is the abstract along with the MedLine

reference:

Chronic pancreatitis. Long-term pain relief with or without surgery,

cancer risk, and mortality.

Thuluvath PJ, Imperio D, Nair S, Cameron JL.

Department of Medicine, The s Hopkins University School of

Medicine, Baltimore, land 21287, USA. pjthuluv@...

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.

Publication Types:

Review

Review, Tutorial

PMID: 12544201 [PubMed - indexed for MEDLINE]

My summary: overall, it dies not matter if you are a drinker or a non-

drinker; this disease will treat you the same way and will be treated

the same!!

Anyse