Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6884
Peer-review started: June 7, 2017
First decision: July 27, 2017
Revised: August 13, 2017
Accepted: September 6, 2017
Article in press: September 5, 2017
Published online: October 7, 2017
Processing time: 114 Days and 15 Hours
To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.
This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center. Data on demographics, medical history, alcohol consumption, smoking habit, clinical parameters, type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed. The absence or substantial reduction of pain (mild pain) at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success.
Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period, 39 (23.21%) had optimal response to the medical therapy. One hundred and twenty-nine patients required endoscopic treatment. The median follow-up period was 15 mo (range, 0-60 mo). Overall, technical success of endotherapy was achieved in 105 patients (81.39%). More than two-thirds of patients (82.78%) had substantial improvement of pain after the endoscopic treatment, including frequency and severity of the pain attacks. Patients younger than 40 years had significantly more successful endoscopic procedures (P = 0.041). Clinical success was higher in non-smoking patients (P = 0.003). The hospital admission rate was higher in patients with recognized alcohol consumption (P = 0.03) and in smokers (P = 0.027). The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success (P > 0.05) or the clinical success (P > 0.05).
Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.
Core tip: We evaluated the endoscopic treatment efficacy and prognostic factors of long-term response in painful chronic pancreatitis. Technical and clinical success was achieved in more than two-thirds of patients. Patients younger than 40 years had significantly more successful endoscopic procedures. Non-smoking patients had greater clinical success. Also, the hospital admission rate was higher in patients with recognized alcohol consumption and in smokers. Number and location of pancreatic stones and locations of strictures did not significantly influence the technical or clinical success. Younger age can be considered an important factor that positively influences the endoscopic treatment outcome in these patients.