TY - JOUR
T1 - International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club
AU - for the Working Group for the International (IAP – APA – JPS – EPC) Consensus Guidelines for Chronic Pancreatitis
AU - Whitcomb, David C.
AU - Shimosegawa, Tooru
AU - Chari, Suresh T.
AU - Forsmark, Christopher E.
AU - Frulloni, Luca
AU - Garg, Pramod
AU - Hegyi, Peter
AU - Hirooka, Yoshiki
AU - Irisawa, Atsushi
AU - Ishikawa, Takuya
AU - Isaji, Shuiji
AU - Lerch, Markus M.
AU - Levy, Philippe
AU - Masamune, Atsushi
AU - Wilcox, Charles M.
AU - Windsor, John
AU - Yadav, Dhiraj
AU - Sheel, Andrea
AU - Neoptolemos, John P.
N1 - Funding Information:
Celeste Shelton MS, critical review of the manuscript. Research reported in this publication was supported by a Clinical Research Training Fellowship , Royal College of Surgeons of England, London UK (AS), the Heidelberger Stiftung Chirurgie, University of Heidelberg, Germany (JPN) , the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award numbers: U01DK108306 (DCW, DY), UO1DK108288 (STC) and U01DK108320 (CF) where the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2018
PY - 2018/7
Y1 - 2018/7
N2 - Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.
AB - Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.
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U2 - 10.1016/j.pan.2018.05.008
DO - 10.1016/j.pan.2018.05.008
M3 - Article
AN - SCOPUS:85048820190
VL - 18
SP - 516
EP - 527
JO - Pancreatology
JF - Pancreatology
SN - 1424-3903
IS - 5
ER -