Skip to main content
Erschienen in: Digestive Diseases and Sciences 7/2017

09.03.2017 | Review

Complications of Chronic Pancreatitis

verfasst von: Mitchell L. Ramsey, Darwin L. Conwell, Phil A. Hart

Erschienen in: Digestive Diseases and Sciences | Ausgabe 7/2017

Einloggen, um Zugang zu erhalten

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.
Literatur
2.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat Forsmark CE. Management of chronic pancreatitis. Gastroenterology. 2013;144:e3.CrossRef Forsmark CE. Management of chronic pancreatitis. Gastroenterology. 2013;144:e3.CrossRef
19.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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.
Zurück zum Zitat 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
Metadaten
Titel
Complications of Chronic Pancreatitis
verfasst von
Mitchell L. Ramsey
Darwin L. Conwell
Phil A. Hart
Publikationsdatum
09.03.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 7/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4518-x

Weitere Artikel der Ausgabe 7/2017

Digestive Diseases and Sciences 7/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

CAR-M-Zellen: Warten auf das große Fressen

22.05.2024 Onkologische Immuntherapie Nachrichten

Auch myeloide Immunzellen lassen sich mit chimären Antigenrezeptoren gegen Tumoren ausstatten. Solche CAR-Fresszell-Therapien werden jetzt für solide Tumoren entwickelt. Künftig soll dieser Prozess nicht mehr ex vivo, sondern per mRNA im Körper der Betroffenen erfolgen.

Frühzeitige HbA1c-Kontrolle macht sich lebenslang bemerkbar

22.05.2024 Typ-2-Diabetes Nachrichten

Menschen mit Typ-2-Diabetes von Anfang an intensiv BZ-senkend zu behandeln, wirkt sich positiv auf Komplikationen und Mortalität aus – und das offenbar lebenslang, wie eine weitere Nachfolgeuntersuchung der UKPD-Studie nahelegt.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.