Prognostic factors of response to endoscopic treatment in painful chronic pancreatitis

Table 1 Demographic, etiological and clinical characteristics of patients at study entry, [n = 129, n (%)]

Sex as male/female	106 (82.17)/23 (17.83)
Age (mean ± SD, yr)	51.55 ± 11.34)
Etiology
Alcoholic	102 (79.07)
Autoimmune	2 (1.55)
Genetic	2 (1.55)
Idiopathic	13 (10.08)
Metabolic	3 (2.33)
Pancreas divisum	7 (5.43)
Pain pattern: continuous/intermittent	22 (17.05)/107 (82.95)
Pain intensity: severe/moderate	57 (44.19)/72 (55.81)
Diabetes	41 (31.78)
Diarrhea	63 (48.84)

Table 2 Technical and clinical success according to the initial pancreatography n (%)

	n	Technical success	Clinical success
All patients	129	105 (81.39)	101 (78.29)
Only pancreatic stones	17	14 (82.35)	13 (76.47)
Cephalic	16
Non-cephalic	1
Cephalic and non-cephalic	0
Only pancreatic strictures	89	71 (79.77)	69 (81.18)
Cephalic	82
Non-cephalic	5
Cephalic and non-cephalic	2
Pancreatic strictures + stones	23	20 (86.95)	19 (95)
Cephalic stones + cephalic strictures	19
Cephalic stones + cephalic and non-cephalic strictures	2
Cephalic and non-cephalic stones + cephalic strictures	2

Table 3 Clinical and technical success according to number and size of stones n (%)

	Technical success				Clinical success
	Yes1	No2	OR (95%CI)	P-value	Yes1	No2	OR (95%CI)	P value
Stone number, median (IQR)	2 (1-2)	1 (1-1.75)	0.28 (0.004-5.96)	0.39	2 (1-2)	1 (1-1)	0.36 (0.03-3.64)	0.098
Stone size, n	34	6			32	5
5-10 mm, n = 14	12 (80)	3 (20)		0.073	11 (78.57)	3 (21.43)		0.346
< 5 mm, n = 23	22 (91.67)	2 (8.33)			21 (91)	2 (8.7)
< 10 mm, n = 1	-	1			-	-

¹Technical or clinical success achieved;

²Failure of endoscopic treatment and no pain improvement. IQR: Interquartile range.

Table 4 Hospital admissions and procedures in patients with endoscopic treatment (technical success vs failure of endoscopic treatment) (n = 122)

	Technical success
	Yes, n = 105	No, n = 17	P value
Hospital admissions	3 (3-5)	3 (3-5)	0.728
ERCP/patient	2 (1-3)	2 (1-2)	0.605
Procedures/patient	3 (1-4)	2 (0-3)	0.055

Data are presented as median (IQR). IQR: Interquartile range; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 5 Pain evolution in patients with endoscopic treatment [n = 122, n (%)]

	Technical success
	Yes, n = 105	No, n = 17	OR (95%CI)	P value
Pain reduction	104 (99.05)	13 (76.47)	30.3 (2.7-1572.8)	0.001
Final pain
Absent	52 (49.52)	1 (5.88)	Absent vs others:
Mild	49 (46.67)	5 (29.415)	15.4 (2.2-668.6)	< 0.001
Moderate	4 (3.81)	11 (64.71)	Absent + mild vs moderate + severe: 42.8 (9.5-245.0)
Severe	-	-

Table 6 Endoscopic drainage (endoscopic retrograde cholangiopancreatography and procedures/patients) according to initial pancreatography changes (n = 122)

	Stones,	Strictures,	Strictures + stones, n = 20	P value
	n = 17	n = 85
ERCP/patient1	2 (1-3)	2 (1-2)c	2 (2-3)c	< 0.001
Procedures/patient1	3 (2-5)a	2 (1-3)c	4 (3-4)ac	< 0.001
Only one procedure	0	23	0	< 0.001
Multiple procedures	17	62	20	< 0.001
Clinical success	13	69	19	0.221

¹Data are presented as median (IQR).

^aP < 0.05, vs the groups with Stones to the group Strictures + Stones had a;

^cP < 0.05, vs the groups with Strictures to the group Strictures + Stones had a. IQR: Interquartile range; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 7 Smoking and alcohol drinking influence on clinical success and technical success [n = 122, n (%)]

				Technical success							Clinical success
	Yes		No		OR (95%CI) vs none	P value	P value overall	Yes		No		OR (95%CI) vs none	P value	P value over all
Smoker only, n = 11	8 (66.67)		3 (33.3)		0.16 (0.02-1.15)	0.036		7 (63.64)		4 (36.36)		0.05 (0.001-0.59)	0.006
Alcohol only, n = 36	31 (77.5)		5 (22.5)		0.27 (0.04-1.20)	0.064		30 (83.33)		6 (16.67)		0.13 (0.003-1.17)	0.048
							0.103							0.007
Non-smoker and non-alcohol, n = 40	39 (92.8)		1 (7.14)		-	-		39 (97.5)		1 (2.5)		-	-
Smoker and alcohol, n = 35	27 (77.1)		8 (22.8)		0.26 (0.04-1.23)	0.099		25 (71.43)		10 (28.5)		0.066 (0.001-0.52)	0.002