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10.1097/MPA.0000000000000237

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suck abstract from ncbi


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pmid25333398
      Pancreas 2014 ; 43 (8 ): 1143-62
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  • American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines #MMPMID25333398
  • Conwell DL ; Lee LS ; Yadav D ; Longnecker DS ; Miller FH ; Mortele KJ ; Levy MJ ; Kwon R ; Lieb JG ; Stevens T ; Toskes PP ; Gardner TB ; Gelrud A ; Wu BU ; Forsmark CE ; Vege SS
  • Pancreas 2014[Nov]; 43 (8 ): 1143-62 PMID25333398 show ga
  • The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed, and evidence-based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable, or insufficient evidence. A diagnostic (STEP-wise; survey, tomography, endoscopy, and pancreas function testing) algorithm is proposed that proceeds from a noninvasive to a more invasive approach. This algorithm maximizes specificity (low false-positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Furthermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (toxic, idiopathic, genetic, autoimmune, recurrent, and obstructive) etiology, gland morphology (Cambridge criteria), and physiologic state (exocrine, endocrine function) for uniformity across future multicenter research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves.
  • |Calcinosis/diagnosis/pathology [MESH]
  • |Cholangiopancreatography, Magnetic Resonance [MESH]
  • |Chymotrypsin/analysis [MESH]
  • |Diagnosis, Differential [MESH]
  • |Disease Progression [MESH]
  • |Endoscopy, Digestive System [MESH]
  • |Endosonography [MESH]
  • |Evidence-Based Medicine [MESH]
  • |Feces/enzymology [MESH]
  • |Humans [MESH]
  • |Incidence [MESH]
  • |Pancreatic Elastase/analysis [MESH]
  • |Pancreatic Function Tests [MESH]
  • |Pancreatic Neoplasms/diagnosis [MESH]
  • |Pancreatitis, Alcoholic/epidemiology [MESH]
  • |Pancreatitis, Chronic/*diagnosis/epidemiology/etiology/pathology/physiopathology [MESH]
  • |Risk Factors [MESH]
  • |Secretin [MESH]
  • |Sensitivity and Specificity [MESH]
  • |Severity of Illness Index [MESH]
  • |Smoking/adverse effects [MESH]
  • |Steatorrhea/etiology [MESH]


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