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. 2022 May;10(4):385-395.
doi: 10.1002/ueg2.12228. Epub 2022 Apr 9.

Structural imaging findings are related to clinical complications in chronic pancreatitis

Ingrid Kvåle Nordaas  1   2 , Erling Tjora  3   4 , Georg Dimcevski  2 , Ingfrid S Haldorsen  5 , Søren Schou Olesen  6   7 , Asbjørn Mohr Drewes  6   7 , Kristina Zviniene  8 , Giedrius Barauskas  9 , Berivan Kyed Bayram  10 , Peter Nørregaard  10 , Anders Borch  11 , Camilla Nøjgaard  12 , Annette Bøjer Jensen  13 , Svetlana S Kardasheva  14 , Alexey Okhlobystin  14 , Truls Hauge  15 , Anne Waage  16 , Jens Brøndum Frøkjaer  8 , Trond Engjom  1   2 ; Scandinavian Baltic Pancreatic Club
Affiliations

Structural imaging findings are related to clinical complications in chronic pancreatitis

Ingrid Kvåle Nordaas et al. United European Gastroenterol J. 2022 May.

Abstract

Background/objectives: Structural pancreatic changes and complications related to chronic pancreatitis are well described, but little is known about their relationship. We aimed to explore the associations between pancreatic morphology and clinical complications in a large chronic pancreatitis cohort.

Methods: The Scandinavian Baltic Pancreatic Club database collects registrations on patients with definite or probable chronic pancreatitis according to the M-ANNHEIM diagnostic criteria. In this cross-sectional study, we used multivariate logistic regression analyses to evaluate whether imaging-based structural pancreatic changes were associated with common clinical complications. We adjusted for sex, age, disease duration, current alcohol abuse and current smoking.

Results: We included 742 patients with a mean age of 55 years. Among these, 68% were males, 69% had pancreatic exocrine insufficiency, 35% had diabetes, 12% were underweighted and 68% reported abdominal pain. Main pancreatic duct obstruction, severe (i.e. more than 14) calcifications, pancreatic atrophy and parenchymal changes throughout the entire pancreas (continuous organ involvement) were positively associated with pancreatic exocrine insufficiency. Continuous organ involvement and pseudocysts were positively and negatively associated with diabetes, respectively. Pancreatic atrophy and severe calcifications were positively associated with underweight, and severe calcifications were negatively associated with pain.

Conclusions: This study shows independent associations between distinct structural changes on pancreatic imaging and clinical complications in chronic pancreatitis. Pancreatic atrophy, severe calcifications and continuous organ involvement may be of particular clinical relevance, and these findings should motivate monitoring of pancreatic function and nutritional status.

Keywords: diabetes mellitus; exocrine pancreatic insufficiency; pain; pancreas; underweight.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Inclusion flow diagram. CP, chronic pancreatitis; SBPC, Scandinavian Baltic Pancreatic Club
FIGURE 2
FIGURE 2
Forest plots display the Odds ratios (circles) with 95% confidence intervals (whiskers) from the multivariate analysis of each factor analyzed: pancreatic exocrine insufficiency (a), diabetes (b), underweight (c) and pain (d). Adjusted for age, sex, disease duration, current drinking and current smoking. MPD, main pancreatic duct
See this image and copyright information in PMC

Comment in

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