Studies on clinical course and prognosis of chronic pancreatitis Part 1. Chief complaint, pancreatogram, exocrine function and glucose tolerance at diagnosis, and their serial changes

To clarify the chief complaints, pancreatograms, pancreatic exocrine function and glucose tolerance at diagnosis and their serial changes in chronic pancreatitis (CP), 112 patients with alcoholic CP, nine with biliary CP and 49 with idiopathic CP were studied. The following conclusions were obrained. Seventy-seven patients with alcoholic CP, nine with biliary CP and 22 with idiopahtic CP had presented with recurrent abdominal pain for more than one year before the time of diagnosis. Chief complaints consisted of abdominal pain , diabetes mellitus and others. Proportion of patients with abdominal pain was significantly higher in alcoholic CP than in idiopathic CP. Elderly patients with CP presented with abdominal pain less frequently than non-elderly patients. These findings indicate that chronic pancreatitis should be considered when diagnosing and treating diabetics and the elderly. Patients with alcoholic CP were significantly younger than those with nonalcoholic CP at diagnosis. Sex distribution showed male predominance in alcoholic CP and female predominance in nonalcoholic CP. Calcification in the pancreas was detected more frequently in alcoholic CP than in nonalcoholic CP. The number of patients with CP increased in more recent years. Alcoholic CP showed more severe damage of the pancreas than nonalcoholic CP at the time of diagnosis. No differences between alcoholic CP and nonalcoholic CP were found in the frequency of the progressive changes in pancreatograms. Deteriorative changes in pancreatic exocrine function were not related with etiological category, but improvement was observed frequently in nonalcoholic CP. The deterioration of glucose tolerance was not related with etiological category, drinking habit and pain relief.

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