Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2008; 14(40): 6171-6179
Published online Oct 28, 2008. doi: 10.3748/wjg.14.6171
Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?
Luis Aparisi, Luis Sabater, Juan Del-Olmo, Juan Sastre, Miguel-Angel Serra, Ricardo Campello, Daniel Bautista, Abdalla Wassel, José-Manuel Rodrigo
Luis Aparisi, Juan Del-Olmo, Miguel-Angel Serra, Abdalla Wassel, José-Manuel Rodrigo, Liver Unit, Universitary Clinic Hospital, Valencia 46010, Spain
Luis Sabater, Department of Surgery, Universitary Clinic Hospital, Valencia 46010, Spain
Juan Sastre, Department of Physiology, University of Valencia, Valencia 46010, Spain
Ricardo Campello, Unit of Psiquiatry, Servicio Valenciano de Salud, Valencia 46010, Spain
Daniel Bautista, Department of Preventive Medicine, Hospital Dr. Peset, Valencia 46010, Spain
Author contributions: Aparisi L, Sabater L and Sastre J contributed to the research design and preparation of the manuscript; Aparisi L, Del-Olmo J, Serra MA, Campello R, Wassel A and Rodrigo JM did patient evaluation and data collection; Bautista D made statistical analysis.
Supported by Grants SAF2006-06963 and CSD2007-00020 from Ministerio de Educación y Ciencia
Correspondence to: Dr. Luis Aparisi, Liver Unit, Hospital Clínico Universitario, Avda. Blasco Ibañez 17, Valencia 46010, Spain.
Telephone: +34-963862600 Fax: +34-963862644
Received: April 15, 2008
Revised: June 23, 2008
Accepted: June 30, 2008
Published online: October 28, 2008

AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes.

METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed.

RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients.

CONCLUSION: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

Keywords: Alcoholic chronic pancreatitis, Alcoholic liver cirrhosis, Alcoholism, Pancreatic function, Hepatic function