TY - JOUR
T1 - Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India
AU - Balakrishnan, Vallath
AU - Unnikrishnan, Ambika Gopalakrishnan
AU - Thomas, Varghese
AU - Choudhuri, Gourdas
AU - Veeraraju, Peda
AU - Singh, Shivram Prasad
AU - Garg, Pramod
AU - Pai, Cannore Ganesh
AU - Devi, Raveendranathan Nair Sobhana
AU - Bhasin, Deepak
AU - Jayanthi, Venkataraman
AU - Premalatha, Narayanan
AU - Chacko, Ashok
AU - Kar, Premashish
AU - Rai, Ramesh Roop
AU - Rajan, Ramesh
AU - Subhalal, Narayanan
AU - Mehta, Rajiv
AU - Mishra, Sri Prakash
AU - Dwivedi, Manisha
AU - Vinayakumar, Kattoor Ramakrishnan Nair
AU - Jain, Ashok Kumar
AU - Biswas, Kalidas
AU - Mathai, Sunil
AU - Varghese, Jaison
AU - Ramesh, Hariharan
AU - Alexander, Thomas
AU - Philip, Jacob
AU - Raj, Vigna Venugopal
AU - Vinodkumar, Ankarath
AU - Mukevar, Srikanth
AU - Sawant, Prabha
AU - Nair, Prem
AU - Kumar, Harish
AU - Sudhindran, Surendran
AU - Dhar, Puneet
AU - Sudheer, Othayil Vayoth
AU - Sundaram, Karimassery Ramaiyer
AU - Tantri, Bailuru Vishwanath
AU - Singh, Devinder
AU - Nath, Thekkayil Rajindra
PY - 2008/12/3
Y1 - 2008/12/3
N2 - Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2%) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7%); the rest (n=11; 1.1%) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3%) and 189 (18.3%) subjects, respectively. Using well-defined criteria, only 39 (3.8%)cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0%). Four hundred and eighteen (40.5%) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8%) and biliary obstruction (8.2%). Pancreatic cancer occurred in 42 subjects (4.1%). Ultrasound detected calculi in 69.7%, ductal dilatation in 63.4% and atrophy in 27.3%. The majority of patients were on medical therapy (n=849; 82.2%); endotherapy and surgery accounted for the rest. About 50% percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.
AB - Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2%) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7%); the rest (n=11; 1.1%) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3%) and 189 (18.3%) subjects, respectively. Using well-defined criteria, only 39 (3.8%)cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0%). Four hundred and eighteen (40.5%) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8%) and biliary obstruction (8.2%). Pancreatic cancer occurred in 42 subjects (4.1%). Ultrasound detected calculi in 69.7%, ductal dilatation in 63.4% and atrophy in 27.3%. The majority of patients were on medical therapy (n=849; 82.2%); endotherapy and surgery accounted for the rest. About 50% percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.
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M3 - Article
C2 - 18762690
AN - SCOPUS:56849097378
SN - 1590-8577
VL - 9
SP - 593
EP - 600
JO - Journal of the Pancreas
JF - Journal of the Pancreas
IS - 5
ER -
