Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2021; 27(27): 4342-4357
Published online Jul 21, 2021. doi: 10.3748/wjg.v27.i27.4342
Comprehensive review of diagnostic modalities for early chronic pancreatitis
Qi-Chao Ge, Christoph F Dietrich, Manoop S Bhutani, Bao-Zhen Zhang, Yue Zhang, Yi-Dan Wang, Jing-Jing Zhang, Yu-Fan Wu, Si-Yu Sun, Jin-Tao Guo
Qi-Chao Ge, Bao-Zhen Zhang, Yue Zhang, Yi-Dan Wang, Jing-Jing Zhang, Yu-Fan Wu, Si-Yu Sun, Jin-Tao Guo, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Christoph F Dietrich, Department Allgemeine Innere Medizin, Salem und Permanence, Bern CH-3000, Switzerland
Manoop S Bhutani, Department of Gastrointestinal, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Author contributions: Ge QC performed the majority of writing and prepared the tables; Zhang Y and Zhang BZ provided inputs for this paper; Wang YD and Zhang JJ took part in the design of the outline; Wu YF coordinated the writing of the paper; Sun SY, Guo JT, Dietrich CF, and Bhutani MS were responsible for the revision of the manuscript for important intellectual content; all the authors read and gave their final approval of the version to be submitted.
Supported by National Natural Science Foundation of China, No. 81900601; Outstanding Scientific Fund of Shengjing Hospital, No. 201702; and University Innovation Team and Innovative Talent Support Program of Liaoning Province, No. LR2019073.
Conflict-of-interest statement: The authors declare no relevant conflict of interest for this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Jin-Tao Guo, MD, PhD, Doctor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China.
Received: April 6, 2021
Peer-review started: April 6, 2021
First decision: May 27, 2021
Revised: June 3, 2021
Accepted: June 17, 2021
Article in press: June 17, 2021
Published online: July 21, 2021

Chronic pancreatitis (CP) is a progressive condition caused by several factors and characterised by pancreatic fibrosis and dysfunction. However, CP is difficult to diagnose at an early stage. Various advanced methods including endoscopic ultrasound based elastography and confocal laser endomicroscopy have been used to diagnose early CP, although no unified diagnostic standards have been established. In the past, the diagnosis was mainly based on imaging, and no comprehensive evaluations were performed. This review describes and compares the advantages and limitations of the traditional and latest diagnostic modalities and suggests guidelines for the standardisation of the methods used to diagnose early CP.

Keywords: Chronic pancreatitis, Pancreatic fibrosis, Early diagnosis, Ultrasound endoscopy, Endosonography, Elastography, Confocal laser endomicroscopy

Core Tip: Chronic pancreatitis (CP) is a progressive disease that is difficult to diagnose at an early stage. This review evaluates the characteristics, strengths, and limitations of modalities for the diagnosis of early CP. This paper will be of interest to the readership because the information presented here highlights multiple novel strategies, such as elastography and confocal laser endomicroscopy, some of which require further research and development to improve the diagnostic efficiency. This review will be highly beneficial for researchers and clinicians focusing on the management of this condition.