TY - JOUR

T1 - Structural imaging findings are related to clinical complications in chronic pancreatitis

AU - Nordaas, Ingrid Kvåle

AU - Tjora, Erling

AU - Dimcevski, Georg

AU - Haldorsen, Ingfrid S.

AU - Olesen, Søren Schou

AU - Drewes, Asbjørn Mohr

AU - Zviniene, Kristina

AU - Barauskas, Giedrius

AU - Bayram, Berivan Kyed

AU - Nørregaard, Peter

AU - Borch, Anders

AU - Nøjgaard, Camilla

AU - Jensen, Annette Bøjer

AU - Kardasheva, Svetlana S.

AU - Okhlobystin, Alexey

AU - Hauge, Truls

AU - Waage, Anne

AU - Frøkjær, Jens Brøndum

AU - Engjom, Trond

AU - Scandinavian Baltic Pancreatic Club

N1 - Publisher Copyright: © 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - diabetes mellitus

KW - exocrine pancreatic insufficiency

KW - pain

KW - pancreas

KW - underweight

U2 - 10.1002/ueg2.12228

DO - 10.1002/ueg2.12228

M3 - Journal article

C2 - 35396813

AN - SCOPUS:85128181042

VL - 10

SP - 385

EP - 395

JO - United European Gastroenterology Journal

JF - United European Gastroenterology Journal

SN - 2050-6406

IS - 4

ER -