Retrospective Study
Copyright ©The Author(s) 2016.
World J Gastroenterol. Dec 21, 2016; 22(47): 10415-10423
Published online Dec 21, 2016. doi: 10.3748/wjg.v22.i47.10415
Table 7 M-ANNHEIM scoring system for the grading of clinical features of chronic pancreatitis
Clinical featuresPoints
Patient report of pain
No pain without therapy(patient reports requiring no pain medication)0
Recurrent acute pancreatitis(patient reports freedom from pain between attacks of acute pancreatitis)1
No pain with therapy(patient reports freedom from pain with pain medication or endoscopic intervention)2
Intermittent pain(patient reports intermittent pain-free episodes, either with or without therapy; possibly additional attacks of acute pancreatitis)3
Continuous pain(patient reports absence of pain-free episodes, either with or without therapy; possibly additional attacks of acute pancreatitis)4
Pain control1
No medication0
Use of non-opioid drugs or use of mild opioids (WHO step 1 or 2)1
Use of potent opioids (WHO step 3) or endoscopic intervention2
Surgical intervention12
Pancreatic surgical intervention for any reason4
Exocrine insufficiency3
Absence of exocrine insufficiency0
Presence of mild, moderate, or unproven exocrine insufficiency not requiring enzyme supplementation (including patient reports of intermittent diarrhea)1
Presence of proven exocrine insufficiency (according to exocrine function tests) or presence of marked exocrine insufficiency defined as steatorrhea (> 7 g fac/24 h), normalized or markedly reduced by enzyme supplementation2
Endocrine insufficiency
Absence of diabetes mellitus0
Presence of diabetes mellitus4
Morphologic status on pancreatic imaging (according to the Cambridge classification)
Severe organ complication2 (not included in the Cambridge classification)
Absence of complications0
Presence of possibly reversible complication42
Presence of irreversible complications44