A master thesis from Aalborg University
Clinical course and prognosis of medically managed patients with small vs. large duct chronic pancreatitis
Author(s)
Term
5. Term (Master thesis)
Education
Publication year
2022
Submitted on
2022-01-05
Pages
11 pages
Abstract
Background and Aim: The clinical course and prognosis of medically managed patients with small duct and large duct chronic pancreatitis (CP) has been scarcely investigated. We inves- tigated all-cause mortality and progression of endocrine and exocrine function in a medically managed cohort of patients with small duct CP and compared them to patients with large duct CP. Methods: This was a retrospective cohort study of 198 consecutive patients with definitive CP according to M-ANNHEIM criteria. Patients were classified as large or small duct cases based on pancreatic duct morphology on cross sectional imaging. We compared all-cause mortality and rates of diabetes and exocrine insufficiency (EPI) between patient subgroups using Kaplan-Meier and multivariate-adjusted Cox Proportional Hazard Models. In a subgroup of patients with follow-up imaging studies, changes in anteroposterior (AP) diameter of the pancreatic head (n=120) and body (n=122) as well as changes in pancreatic duct morphology (n=121) was studied. Results: The mean age of subjects were 58 ± 12 years and 70% were male. Large duct CP was seen in 75 patients (38%) and small duct CP by 123 patients (62%). The five-year mortality rate was compared between patient subgroups (HR: 1.07; 95% CI 0.56–2.07) as was the rate of new onset diabetes (HR: 1.55; 95% CI 0.77–3.13). In contrast, new onset of EPI was more prevalent in patients with large duct CP (HR: 1.77; 95% CI 1.10–2.86; P=0.019). Large duct CP was also associated with greater loss of pancreatic parenchyma in the head (coefficient -2.9 mm; 95% CI -4.0– -1.6; P<0.001). Seventeen (14%) with follow-up imaging changed their pan- creatic duct morphology at follow-up, with the majority of patients developing large duct dis- ease (82%). Conclusion: Medically managed patients with large duct CP have an excess risk of EPI and pancreatic atrophy compared to their counterparts with small duct CP.
Keywords
Documents
Colophon: This page is part of the AAU Student Projects portal, which is run by Aalborg University. Here, you can find and download publicly available bachelor's theses and master's projects from across the university dating from 2008 onwards. Student projects from before 2008 are available in printed form at Aalborg University Library.
If you have any questions about AAU Student Projects or the research registration, dissemination and analysis at Aalborg University, please feel free to contact the VBN team. You can also find more information in the AAU Student Projects FAQs.