Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2017; 23(37): 6884-6893
Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6884
Prognostic factors of response to endoscopic treatment in painful chronic pancreatitis
Alina Tantau, Alina Mandrutiu, Daniel-Corneliu Leucuta, Lidia Ciobanu, Marcel Tantau
Alina Tantau, Lidia Ciobanu, Marcel Tantau, Department of Internal Medicine and Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
Alina Tantau, Department of Internal Medicine and Gastroenterology, 4th Medical Clinic, Cluj-Napoca City, 400015 Cluj, Romania
Alina Mandrutiu, Department of Gastroenterology, Gastroenterology and Hepatology Medical Center, Cluj-Napoca City, 400132 Cluj, Romania
Daniel-Corneliu Leucuta, Medical Informatics and Biostatistics Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca City, 400012 Cluj, Romania
Lidia Ciobanu, Marcel Tantau, Department of Internal Medicine and Gastroenterology, “Prof. Dr. Octavian Fodor“ Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca City, 400158 Cluj, Romania
Author contributions: Tantau A made a substantial contribution to the conception and design of the study and interpretation of data, and revised the manuscript for important intellectual content; Mandrutiu A collected and analyzed the data, and drafted the manuscript; Leucuta DC provided analytical oversight; Ciobanu L revised the manuscript, Tantau M designed and supervised the study and revised the manuscript for important intellectual content; All authors have read and approved the final version to be published.
Institutional review board statement: This study was reviewed and approved by the “Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology, Hospital Institutional Review Board (261/29.06.2016).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare that no conflicts of interest.
Data sharing statement: The technical appendix, statistical code and dataset of the manuscript are available from the corresponding author at office@doctortantau.ro. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alina Mandrutiu, MD, Department of Gastroenterology, Gastroenterology and Hepatology Medical Center, Cluj-Napoca City, 400132 Cluj, Romania. office@doctortantau.ro
Telephone: + 40-740-103108 Fax: +40-26-443910
Received: June 5, 2017
Peer-review started: June 7, 2017
First decision: July 27, 2017
Revised: August 13, 2017
Accepted: September 6, 2017
Article in press: September 5, 2017
Published online: October 7, 2017
Abstract
AIM

To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.

METHODS

This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center. Data on demographics, medical history, alcohol consumption, smoking habit, clinical parameters, type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed. The absence or substantial reduction of pain (mild pain) at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success.

RESULTS

Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period, 39 (23.21%) had optimal response to the medical therapy. One hundred and twenty-nine patients required endoscopic treatment. The median follow-up period was 15 mo (range, 0-60 mo). Overall, technical success of endotherapy was achieved in 105 patients (81.39%). More than two-thirds of patients (82.78%) had substantial improvement of pain after the endoscopic treatment, including frequency and severity of the pain attacks. Patients younger than 40 years had significantly more successful endoscopic procedures (P = 0.041). Clinical success was higher in non-smoking patients (P = 0.003). The hospital admission rate was higher in patients with recognized alcohol consumption (P = 0.03) and in smokers (P = 0.027). The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success (P > 0.05) or the clinical success (P > 0.05).

CONCLUSION

Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.

Keywords: Pain, Chronic pancreatitis, Endoscopic procedures, Alcohol, Smoking, Hospital admission, Technical success, Clinical success

Core tip: We evaluated the endoscopic treatment efficacy and prognostic factors of long-term response in painful chronic pancreatitis. Technical and clinical success was achieved in more than two-thirds of patients. Patients younger than 40 years had significantly more successful endoscopic procedures. Non-smoking patients had greater clinical success. Also, the hospital admission rate was higher in patients with recognized alcohol consumption and in smokers. Number and location of pancreatic stones and locations of strictures did not significantly influence the technical or clinical success. Younger age can be considered an important factor that positively influences the endoscopic treatment outcome in these patients.