International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club

for the Working Group for the International (IAP – APA – JPS – EPC) Consensus Guidelines for Chronic Pancreatitis

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Abstract

Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.

Original languageEnglish (US)
Pages (from-to)516-527
Number of pages12
JournalPancreatology
Volume18
Issue number5
DOIs
StatePublished - Jul 1 2018

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Chronic Pancreatitis
Pancreas
Japan
Guidelines
S 10
Politics

Keywords

  • Acute pancreatitis
  • Alcohol
  • Chronic pancreatitis
  • Classification
  • Diagnosis
  • Endoscopic ultrasound
  • Fibrosis
  • Genetic
  • Model

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

Cite this

@article{9ce436a2d3bf49d6ade6924352325ce7,
title = "International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club",
abstract = "Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.",
keywords = "Acute pancreatitis, Alcohol, Chronic pancreatitis, Classification, Diagnosis, Endoscopic ultrasound, Fibrosis, Genetic, Model",
author = "{for the Working Group for the International (IAP – APA – JPS – EPC) Consensus Guidelines for Chronic Pancreatitis} and Whitcomb, {David C.} and Tooru Shimosegawa and Chari, {Suresh T} and Forsmark, {Christopher E.} and Luca Frulloni and Pramod Garg and Peter Hegyi and Yoshiki Hirooka and Atsushi Irisawa and Takuya Ishikawa and Shuiji Isaji and Lerch, {Markus M.} and Philippe Levy and Atsushi Masamune and Wilcox, {Charles M.} and John Windsor and Dhiraj Yadav and Andrea Sheel and Neoptolemos, {John P.}",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.pan.2018.05.008",
language = "English (US)",
volume = "18",
pages = "516--527",
journal = "Pancreatology",
issn = "1424-3903",
publisher = "S. Karger AG",
number = "5",

}

TY - JOUR

T1 - International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club

AU - for the Working Group for the International (IAP – APA – JPS – EPC) Consensus Guidelines for Chronic Pancreatitis

AU - Whitcomb, David C.

AU - Shimosegawa, Tooru

AU - Chari, Suresh T

AU - Forsmark, Christopher E.

AU - Frulloni, Luca

AU - Garg, Pramod

AU - Hegyi, Peter

AU - Hirooka, Yoshiki

AU - Irisawa, Atsushi

AU - Ishikawa, Takuya

AU - Isaji, Shuiji

AU - Lerch, Markus M.

AU - Levy, Philippe

AU - Masamune, Atsushi

AU - Wilcox, Charles M.

AU - Windsor, John

AU - Yadav, Dhiraj

AU - Sheel, Andrea

AU - Neoptolemos, John P.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.

AB - Background: Chronic pancreatitis (CP) is a progressive inflammatory disorder currently diagnosed by morphologic features. In contrast, an accurate diagnosis of Early CP is not possible using imaging criteria alone. If this were possible and early treatment instituted, the later, irreversible features and complications of CP could possibly be prevented. Method: An international working group supported by four major pancreas societies (IAP, APA, JPS, and EPC) and a PancreasFest working group sought to develop a consensus definition and diagnostic criteria for Early CP. Ten statements (S1-10) concerning Early CP were used to gauge consensus on the Early CP concept using anonymous voting with a 9 point Likert scale. Consensus required an alpha ≥0.80. Results: No consensus statement could be developed for a definition of Early-CP or diagnostic criteria. There was consensus on 5 statements: (S2) The word “Early” in early chronic pancreatitis is used to describe disease state, not disease duration. (S4) Early CP defines a stage of CP with preserved pancreatic function and potentially reversible features. (S8) Genetic variants are important risk factors for Early CP and can add specificity to the likely etiology, but they are neither necessary nor sufficient to make a diagnosis. (S9) Environmental risk factors can provide evidence to support the diagnosis of Early CP, but are neither necessary nor sufficient to make a diagnosis. (S10) The differential diagnosis for Early CP includes other disorders with morphological and functional features that overlap with CP. Conclusions: Morphology based diagnosis of Early CP is not possible without additional information. New approaches to the accurate diagnosis of Early CP will require a mechanistic definition that considers risk factors, biomarkers, clinical context and new models of disease. Such a definition will require prospective validation.

KW - Acute pancreatitis

KW - Alcohol

KW - Chronic pancreatitis

KW - Classification

KW - Diagnosis

KW - Endoscopic ultrasound

KW - Fibrosis

KW - Genetic

KW - Model

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U2 - 10.1016/j.pan.2018.05.008

DO - 10.1016/j.pan.2018.05.008

M3 - Article

VL - 18

SP - 516

EP - 527

JO - Pancreatology

JF - Pancreatology

SN - 1424-3903

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