Introduction

Chronic pancreatitis (CP) is a fibroinflammatory syndrome with reduced quality of life (QOL) and shortened life expectancy. Population-based estimates of the incidence and prevalence of CP are scarce in China.

Aims & Methods

Aims: To evaluate the incidence and prevalence of CP and describe the disease burden of CP in Sichuan Province, China.
Methods: Hospital admissions (HA) data for CP from 1 January 2015 to 31 December 2021 were obtained from the Health Information Center of Sichuan Province (HIC-SC). During the study period, 38,086 individuals were diagnosed with CP in Sichuan Province. The yearly incidence rate and point prevalence rate (31 December 2021) of CP were calculated. Disease burden of CP were evaluated. Yearly incidence rates were standardized for age by the direct method using the permanent population of Sichuan Province in the 2020 census as the standard population. Costs for CP were adjusted by the consumer price index (CPI) every year to 2021 costs.

Results

The 38,086 CP patients consisted of 23,278 males and 14,808 females. The mean age at diagnosis of CP was 57.83 years. The mean incidence rate of CP during the study period was 6.81 per 100,000 person-years, and the incidence of CP increased each year. The point prevalence rate of CP in 2021 was 45.52 per 100,000 people for the total population, 55.04 per 100,000 people for men, and 35.78 per 100,000 people for women. The number of CP-related hospitalizations increased from 3,734 in 2015 to 11,009 in 2021. The total costs for CP-related hospitalizations for CP patients over the study period were US$ 103.54 million, with an average of US$ 2718 per patient.

Conclusion

We conducted a population‐based epidemiological study of CP in Sichuan Province, China, from 2015 to 2021. During the study period, the annual incidence of CP in Sichuan Province increased, and by 2021, the prevalence of CP was 45.52 cases per 100,000 person-years for the total population. The number of CP patients and CP-related hospitalization costs increased. Therefore, prevention and treatment of CP are of great importance.

Disclosure

There are no conflicts of interest to report.

Introduction

Chronic pancreatitis (CP) and acute pancreatitis (AP) are known risk factors for pancreatic cancer (PC), but the incidence and risk of PC vary depending on the subtype of pancreatitis.

Aims & Methods

We conducted a population-based cohort study to evaluate the incidence and risk of PC in patients with different subtypes of pancreatitis. We identified patients with AP (n=225,811, 50.0%) and CP (n=225,685, 50.0%) from Korean population-based data and matched them with age- and sex-matched controls (n=4,514,960). We analyzed the incidence and adjusted hazard ratios (aHRs) of PC among patients followed for more than 2 years or 5 years, and annual interval risks in each group, including single AP (SAP), recurrent AP (RAP), CP with AP, and CP without AP. We also performed subgroup analysis for both sexes and adjusted for confounding factors associated with PC.

Results

The incidences (per 10⁵) and risks (aHR) of PC were higher in RAP (12.69, 5.00) or CP with AP (12.12, 5.74) groups compared to SAP (2.31, 1.32) or CP without AP (2.28, 1.57) groups. The annual interval risks of PC decreased over time, with SAP and CP without AP groups showing no increased risk of PC after 3 or 4 years, respectively. However, the risk of PC remained elevated in the RAP and CP with AP groups for more than 8 years. Women with RAP, SAP, and CP with AP had higher risks of PC than men.

Conclusion

Our findings suggest that the risk of PC is higher in patients with RAP and CP with AP than in those with SAP or CP without AP. The risk of PC also persists for a longer time in patients with RAP and CP with AP. Our study provides insights into the incidence and risk of PC in patients with different subtypes of pancreatitis, which can help in the development of effective prevention and screening strategies for PC in this high-risk population.

Introduction

The clinical presentation of chronic pancreatitis (CP) varies between patients, and can include pain, diabetes, exocrine insufficiency, and malnutrition. Studies describing the course of the disease are lacking. The Bergen Pancreatic club collects data from patients with CP in Western Norway, and we present results from the first patients reaching 10-year follow-up.

Aims & Methods

We aimed to describe the disease development of patients with CP in our prospective observational study. Patients with CP were included during the period 2009 to 2021. We used M-ANNHEIM diagnostic criteria for diagnosing CP. The collected data included sex, age, aetiology, bodyweight, smoking status, alcohol use, and data on treatment and complications from CP. Exocrine pancreatic dysfunction (EPD) was defined as faecal elastase <200µg/g.

Results

Upon data extraction in February 2024, 55 patients had reached 10 years after inclusion. Seven patients were lost for follow-up. The remaining 48 patients (30 males) were included for analysis. At time of inclusion, the mean age (SD) was 58 (13) years, 52% had EPD, and 33% had diabetes. Forty-one (85%) were former or active smokers, and 16 (33%) had a daily alcohol intake. Reported aetiologies were alcohol (46%), smoke (66%), efferent duct factors (32%), immunological (7%), hereditary (9%), metabolic (2%), and idiopathic (21%).
Seventeen patients (39%, 11 males) deceased during follow-up. Median age for the deceased where 66 years (range 55-85 years) for females and 73 years (range 44-88 years) for males. The deceased patients had a higher age at inclusion compared to patients alive after 10 years. There were no significant differences in aetiologies or baseline frequencies of current drinkers, smokers, EPD or diabetes between the deceased and surviving patients.
Disease development and treatment during follow-up:
Exocrine function: 20 patients (42%) remained exocrine pancreatic sufficient (EPS), 23 patients (48%) remained EPD, 3 patients (6%) developed EPD, and 2 (4%) regained EPS. Eleven (23%) remained without pancreatic enzyme replacement therapy (PERT), 6 (13%) started PERT, 2 (4%) stopped PERT and 29 (60%) were stable on PERT.
Diabetes: 27 (56%) remained endocrine sufficient, and 5 (10%) developed diabetes. Among the 21 patients who had or developed diabetes, 5 patients used insulin upon inclusion, and 6 started using insulin during the follow-up period.
Pain: Thirty-seven patients (83%) a reported pain at one or more follow-up visits, and 17 patients (35%) used opioids intermittently or regularly during the 10-year follow-up.

Conclusion

There was a high mortality among the CP patients during the 10-year follow-up. A significant portion of subjects continued risk exposures during the whole follow up period. Complications were present in the majority of patients.

Introduction

Chronic pancreatitis (CP) is a progressive inflammatory disorder that predisposes patients to various complications, including vascular events. Among these, splenic vein thrombosis (SVT) represents a siginficant, but often underdiagnosed complication, with reported prevalence rates varying widely. SVT may lead to sinistral portal hypertension, resulting in gastric varices and, in severe cases, life-threatening gastrointestinal hemorrhage. This systematic review and meta-analysis aims to determine the true pooled prevalence of SVT in CP patients and to evaluate the bleeding rate among those with splenic thrombosis by synthesizing data from studies in which all participants underwent appropriate imaging for SVT detection.

Aims & Methods

An exploratory search was conducted to identify key articles reporting on the prevalence of SVT among CP patients. Four studies were selected based on their provision of relevant, poolable data on prevalence with the use of proper imaging techniques for detecting SVT, encompassing a total of 1,973 patients. A random effects meta‐analysis was performed using SPSS, and a forest plot was genrated to visually represent both individual and overall prevalence estimates. An ongoing PRISMA compliant systematic literature search continues to capture all pertinent studies on this topic.

Results

Analysis of data from the four selected studies (n = 1,973) revealed a pooled SVT prevalence of 12.7% in CP patients. Although individual study estimates varied, likely reflecting differences in study design, CP etiology, and follow-up duration, the overall result indicates that approximately one in eight patients with CP develops SVT.

Conclusion

Our preliminary findings demonstrate that, when appropriate imaging is employed, SVT occurs in approximately 12.7% of chronic pancreatitis cases. These results underscore the clinical importance of SVT, particularly given its association with an increased risk of gastrointestinal hemorrhage. Routine evaluation for SVT in CP patients should be considered, and further research is warranted to elucidate underlying risk factors and to refine management strategies for this potentially life-threatening vascular complication.