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Published in: Digestive Diseases and Sciences 7/2017

01-07-2017 | Review

Complications of Chronic Pancreatitis

Authors: Mitchell L. Ramsey, Darwin L. Conwell, Phil A. Hart

Published in: Digestive Diseases and Sciences | Issue 7/2017

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Abstract

Chronic pancreatitis is a disease that leads to irreversible changes in the pancreatic morphology and function. The loss of function can lead to diabetes mellitus and exocrine pancreatic insufficiency. The inflammation and fibrosis can also lead to other complications including a chronic abdominal pain syndrome, metabolic bone disease, and pancretic cancer. This article reviews our current understanding of the mechanisms and management of these complications of chronic pancreatitis.
Literature
2.
go back to reference Hart PA, Bellin M, Andersen DK. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016;1:226–237.CrossRefPubMed Hart PA, Bellin M, Andersen DK. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016;1:226–237.CrossRefPubMed
3.
go back to reference Ewald N, Kaufmann C, Raspe A, et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2012;28:338–342.CrossRefPubMed Ewald N, Kaufmann C, Raspe A, et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2012;28:338–342.CrossRefPubMed
4.
go back to reference Hart PA, Conwell DL. Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol. 2015;13:347–353.CrossRefPubMed Hart PA, Conwell DL. Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol. 2015;13:347–353.CrossRefPubMed
5.
go back to reference Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119:1324–1332.CrossRefPubMed Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology. 2000;119:1324–1332.CrossRefPubMed
7.
go back to reference Lundberg R, Beilman GJ, Dunn TB, et al. Early alterations in glycemic control and pancreatic endocrine function in nondiabetic patients with chronic pancreatitis. Pancreas. 2016;45:565–571.CrossRefPubMedPubMedCentral Lundberg R, Beilman GJ, Dunn TB, et al. Early alterations in glycemic control and pancreatic endocrine function in nondiabetic patients with chronic pancreatitis. Pancreas. 2016;45:565–571.CrossRefPubMedPubMedCentral
8.
go back to reference Brunicardi FC, Chaiken RL, Ryan AS, et al. Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis. J Clin Endocrinol Metab. 1996;81:3566–3572.PubMed Brunicardi FC, Chaiken RL, Ryan AS, et al. Pancreatic polypeptide administration improves abnormal glucose metabolism in patients with chronic pancreatitis. J Clin Endocrinol Metab. 1996;81:3566–3572.PubMed
9.
go back to reference Rickels MR, Bellin M, Toledo FG, et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13:336–342.CrossRefPubMed Rickels MR, Bellin M, Toledo FG, et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13:336–342.CrossRefPubMed
11.
go back to reference Zhou X, You S. Rosiglitazone inhibits hepatic insulin resistance induced by chronic pancreatitis and IKK-beta/NF-kappaB expression in liver. Pancreas. 2014;43:1291–1298.CrossRefPubMed Zhou X, You S. Rosiglitazone inhibits hepatic insulin resistance induced by chronic pancreatitis and IKK-beta/NF-kappaB expression in liver. Pancreas. 2014;43:1291–1298.CrossRefPubMed
12.
go back to reference Forsmark CE. Incretins, diabetes, pancreatitis and pancreatic cancer: what the GI specialist needs to know. Pancreatology. 2016;16:10–13.CrossRefPubMed Forsmark CE. Incretins, diabetes, pancreatitis and pancreatic cancer: what the GI specialist needs to know. Pancreatology. 2016;16:10–13.CrossRefPubMed
13.
go back to reference DiMagno EP, Go VL, Summerskill WH. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med. 1973;288:813–815.CrossRefPubMed DiMagno EP, Go VL, Summerskill WH. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med. 1973;288:813–815.CrossRefPubMed
14.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
15.
go back to reference Hart PA, Topazian M, Raimondo M, et al. Endoscopic pancreas fluid collection: methods and relevance for clinical care and translational science. Am J Gastroenterol. 2016;111:1258–1266.CrossRefPubMed Hart PA, Topazian M, Raimondo M, et al. Endoscopic pancreas fluid collection: methods and relevance for clinical care and translational science. Am J Gastroenterol. 2016;111:1258–1266.CrossRefPubMed
16.
go back to reference Sandhu BS, Hackworth WA, Stevens S, et al. Recurrent flares of pancreatitis predict development of exocrine insufficiency in chronic pancreatitis. Clin Gastroenterol Hepatol. 2007;5:1085–1091. (quiz 1007).CrossRefPubMed Sandhu BS, Hackworth WA, Stevens S, et al. Recurrent flares of pancreatitis predict development of exocrine insufficiency in chronic pancreatitis. Clin Gastroenterol Hepatol. 2007;5:1085–1091. (quiz 1007).CrossRefPubMed
17.
go back to reference Martinez-Moneo E, Stigliano S, Hedstrom A, et al. Deficiency of fat-soluble vitamins in chronic pancreatitis: a systematic review and meta-analysis. Pancreatology. 2016;16:988–994.CrossRefPubMed Martinez-Moneo E, Stigliano S, Hedstrom A, et al. Deficiency of fat-soluble vitamins in chronic pancreatitis: a systematic review and meta-analysis. Pancreatology. 2016;16:988–994.CrossRefPubMed
18.
go back to reference Forsmark CE. Management of chronic pancreatitis. Gastroenterology. 2013;144:e3.CrossRef Forsmark CE. Management of chronic pancreatitis. Gastroenterology. 2013;144:e3.CrossRef
19.
go back to reference Frulloni L, Falconi M, Gabbrielli A, et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42:S381–S406.CrossRefPubMed Frulloni L, Falconi M, Gabbrielli A, et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42:S381–S406.CrossRefPubMed
20.
go back to reference Dominguez-Munoz JE. Pancreatic exocrine insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26:12–16.CrossRefPubMed Dominguez-Munoz JE. Pancreatic exocrine insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26:12–16.CrossRefPubMed
21.
go back to reference Hart PA, Conwell DL. Challenges and updates in the management of exocrine pancreatic insufficiency. Pancreas. 2016;45:1–4.CrossRefPubMed Hart PA, Conwell DL. Challenges and updates in the management of exocrine pancreatic insufficiency. Pancreas. 2016;45:1–4.CrossRefPubMed
22.
go back to reference Duggan SN, Smyth ND, Murphy A, et al. High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:219–228.CrossRefPubMed Duggan SN, Smyth ND, Murphy A, et al. High prevalence of osteoporosis in patients with chronic pancreatitis: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:219–228.CrossRefPubMed
23.
go back to reference Tignor AS, Wu BU, Whitlock TL, et al. High prevalence of low-trauma fracture in chronic pancreatitis. Am J Gastroenterol. 2010;105:2680–2686.CrossRefPubMed Tignor AS, Wu BU, Whitlock TL, et al. High prevalence of low-trauma fracture in chronic pancreatitis. Am J Gastroenterol. 2010;105:2680–2686.CrossRefPubMed
24.
go back to reference Munigala S, Agarwal B, Gelrud A, et al. Chronic pancreatitis and fracture: a retrospective, population-based veterans administration study. Pancreas. 2016;45:355–361.CrossRefPubMed Munigala S, Agarwal B, Gelrud A, et al. Chronic pancreatitis and fracture: a retrospective, population-based veterans administration study. Pancreas. 2016;45:355–361.CrossRefPubMed
26.
go back to reference Algul H, Treiber M, Lesina M, et al. Mechanisms of disease: chronic inflammation and cancer in the pancreas—a potential role for pancreatic stellate cells? Nat Clin Pract Gastroenterol Hepatol. 2007;4:454–462.CrossRefPubMed Algul H, Treiber M, Lesina M, et al. Mechanisms of disease: chronic inflammation and cancer in the pancreas—a potential role for pancreatic stellate cells? Nat Clin Pract Gastroenterol Hepatol. 2007;4:454–462.CrossRefPubMed
27.
go back to reference Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328:1433–1437.CrossRefPubMed Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328:1433–1437.CrossRefPubMed
28.
go back to reference Raimondi S, Lowenfels AB, Morselli-Labate AM, et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol. 2010;24:349–358.CrossRefPubMed Raimondi S, Lowenfels AB, Morselli-Labate AM, et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol. 2010;24:349–358.CrossRefPubMed
29.
go back to reference Chari ST, Mohan V, Pitchumoni CS, et al. Risk of pancreatic carcinoma in tropical calcifying pancreatitis: an epidemiologic study. Pancreas. 1994;9:62–66.CrossRefPubMed Chari ST, Mohan V, Pitchumoni CS, et al. Risk of pancreatic carcinoma in tropical calcifying pancreatitis: an epidemiologic study. Pancreas. 1994;9:62–66.CrossRefPubMed
30.
go back to reference Brodovicz KG, Kou TD, Alexander CM, et al. Impact of diabetes duration and chronic pancreatitis on the association between type 2 diabetes and pancreatic cancer risk. Diabetes Obes Metab. 2012;14:1123–1128.CrossRefPubMed Brodovicz KG, Kou TD, Alexander CM, et al. Impact of diabetes duration and chronic pancreatitis on the association between type 2 diabetes and pancreatic cancer risk. Diabetes Obes Metab. 2012;14:1123–1128.CrossRefPubMed
31.
go back to reference Munigala S, Singh A, Gelrud A, et al. Predictors for pancreatic cancer diagnosis following new-onset diabetes mellitus. Clin Transl Gastroenterol. 2015;6:e118.CrossRefPubMedPubMedCentral Munigala S, Singh A, Gelrud A, et al. Predictors for pancreatic cancer diagnosis following new-onset diabetes mellitus. Clin Transl Gastroenterol. 2015;6:e118.CrossRefPubMedPubMedCentral
32.
go back to reference Agarwal AK, Raj Kumar K, Agarwal S, et al. Significance of splenic vein thrombosis in chronic pancreatitis. Am J Surg. 2008;196:149–154.CrossRefPubMed Agarwal AK, Raj Kumar K, Agarwal S, et al. Significance of splenic vein thrombosis in chronic pancreatitis. Am J Surg. 2008;196:149–154.CrossRefPubMed
33.
go back to reference Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB (Oxford). 2011;13:839–845.CrossRef Butler JR, Eckert GJ, Zyromski NJ, et al. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB (Oxford). 2011;13:839–845.CrossRef
34.
go back to reference Harris S, Nadkarni NA, Naina HV, et al. Splanchnic vein thrombosis in acute pancreatitis: a single-center experience. Pancreas. 2013;42:1251–1254.CrossRefPubMed Harris S, Nadkarni NA, Naina HV, et al. Splanchnic vein thrombosis in acute pancreatitis: a single-center experience. Pancreas. 2013;42:1251–1254.CrossRefPubMed
35.
go back to reference Levy MJ, Wong Kee Song LM. EUS-guided angiotherapy for gastric varices: coil, glue, and sticky issues. Gastrointest Endosc. 2013;78:722–725.CrossRefPubMed Levy MJ, Wong Kee Song LM. EUS-guided angiotherapy for gastric varices: coil, glue, and sticky issues. Gastrointest Endosc. 2013;78:722–725.CrossRefPubMed
36.
go back to reference Varadarajulu S, Bang JY, Sutton BS, et al. Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology. 2013;145:e1.CrossRef Varadarajulu S, Bang JY, Sutton BS, et al. Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology. 2013;145:e1.CrossRef
37.
go back to reference Gurusamy KS, Pallari E, Hawkins N, et al. Management strategies for pancreatic pseudocysts. Cochrane Database Syst Rev. 2016;4:CD011392.PubMed Gurusamy KS, Pallari E, Hawkins N, et al. Management strategies for pancreatic pseudocysts. Cochrane Database Syst Rev. 2016;4:CD011392.PubMed
38.
go back to reference Vijungco JD, Prinz RA. Management of biliary and duodenal complications of chronic pancreatitis. World J Surg. 2003;27:1258–1270.CrossRefPubMed Vijungco JD, Prinz RA. Management of biliary and duodenal complications of chronic pancreatitis. World J Surg. 2003;27:1258–1270.CrossRefPubMed
39.
go back to reference Oza VM, Skeans JM, Muscarella P, et al. Groove pancreatitis, a masquerading yet distinct clinicopathological entity: analysis of risk factors and differentiation. Pancreas. 2015;44:901–908.CrossRefPubMed Oza VM, Skeans JM, Muscarella P, et al. Groove pancreatitis, a masquerading yet distinct clinicopathological entity: analysis of risk factors and differentiation. Pancreas. 2015;44:901–908.CrossRefPubMed
40.
41.
go back to reference Deviere J, Nageshwar Reddy D, Puspok A, et al. Successful management of benign biliary strictures with fully covered self-expanding metal stents. Gastroenterology. 2014;147:385–395. (quiz e15).CrossRefPubMed Deviere J, Nageshwar Reddy D, Puspok A, et al. Successful management of benign biliary strictures with fully covered self-expanding metal stents. Gastroenterology. 2014;147:385–395. (quiz e15).CrossRefPubMed
42.
go back to reference Haapamaki C, Kylanpaa L, Udd M, et al. Randomized multicenter study of multiple plastic stents vs. covered self-expandable metallic stent in the treatment of biliary stricture in chronic pancreatitis. Endoscopy. 2015;47:605–610.CrossRefPubMed Haapamaki C, Kylanpaa L, Udd M, et al. Randomized multicenter study of multiple plastic stents vs. covered self-expandable metallic stent in the treatment of biliary stricture in chronic pancreatitis. Endoscopy. 2015;47:605–610.CrossRefPubMed
Metadata
Title
Complications of Chronic Pancreatitis
Authors
Mitchell L. Ramsey
Darwin L. Conwell
Phil A. Hart
Publication date
01-07-2017
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 7/2017
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4518-x

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