Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Role of EUS in Early Chronic Pancreatitis

Version 1 : Received: 16 January 2024 / Approved: 17 January 2024 / Online: 17 January 2024 (05:55:48 CET)

A peer-reviewed article of this Preprint also exists.

Shah, J.; Chatterjee, A.; Kothari, T.H. The Role of Endoscopic Ultrasound in Early Chronic Pancreatitis. Diagnostics 2024, 14, 298. Shah, J.; Chatterjee, A.; Kothari, T.H. The Role of Endoscopic Ultrasound in Early Chronic Pancreatitis. Diagnostics 2024, 14, 298.

Abstract

Chronic pancreatitis (CP) is an irreversible and progressive inflammation of the pancreas that can involve both pancreatic parenchyma and pancreatic duct. CP results in morphological change in the gland in the form of fibrosis and calcification along with functional impairment in the form of exocrine and endocrine insufficiency. Studies on the natural history of CP reveal the irreversibility of the condition and the resultant plethora of complications of which pancreatic adenocarcinoma is the most dreaded one. (1,2) In Japanese population-based studies by Otsuki and Fuzino et al, CP was clearly shown to reduce lifespan among males and females by 10.5 years and 16 years, respectively. (3) Most of these patients had occult pancreatic malignancies which were diagnosed late and were detected to be the commonest cause of mortality among these patients with a standardized mortality rate of 7.33. (3) This dismal prognosis is superadded with significant morbidity due to pain and poor quality of life rendering a significant burden on health and health-related infrastructure. These factors have led researchers to conceptualize early CP which theoretically is a reversible stage in the disease spectrum characterized by ongoing pancreatic injury with the presence of clinical symptoms and absence of classical imaging features of CP. Subsequently, the disease is thought to go through a compensated stage, a transitional stage, and culminating into decompensated stage with florid evidence of functional impairment of the gland. (4) In this focused review, we will discuss the definition and concept of early CP, risk factors and natural history of the development of CP, and the role of various modalities of EUS in the timely diagnosis of early CP.

Keywords

chronic pancreatitis; alcohol; SPINK1; Abdominal pain

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

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