SpringerLink
Log in

Diagnosis of Chronic Pancreatitis

  • Chapter
  • First Online:
Chronic Pancreatitis

  • 666 Accesses

Abstract

It is difficult to some extent to make the definitive diagnosis of chronic pancreatitis, especially if the disease is not recognized by the physicians treating the patients. Basing on the presence of several different diagnostic characters of the CP, the Zürich workshop on alcoholic chronic pancreatitis proposed a classification in which CP was divided into ‘probable’ and ‘definite’ (Ammann 1997). There is a similar grading recommended by the Japan Pancreas Society (Homma et al. 1997). In 2007, Schneider and his colleagues established a new MANNHEIM classification system referring to the understandings of the Zürich workshop, but they decided to include smaller amounts of alcohol intake as risk factors for the development of CP than before, as well as a subgroup of ‘borderline’ CP into the classification system. The M-ANNHEIM diagnostic criteriaof CP are listed in Table 7.1 (Schneider et al. 2007).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Adler DG, Lichtenstein D, Baron TH, et al. The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc. 2006;63:933–7.

    Article  PubMed  Google Scholar 

  • Affronti J. Chronic pancreatitis and exocrine insufficiency. Prim Care. 2011;38(3):515–37.

    Article  PubMed  Google Scholar 

  • Albashir S, Bronner MP, Parsi MA, et al. Endoscopic ultrasound, secretin endoscopic pancreatic function test, and histology: correlation in chronic pancreatitis. Am J Gastroenterol. 2010;105:2498–503.

    Article  PubMed  Google Scholar 

  • American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):S81–90.

    Article  Google Scholar 

  • Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis: summary of an international workshop on chronic pancreatitis. Pancreas. 1997;14:215–21.

    Article  CAS  PubMed  Google Scholar 

  • Ammann RW. Zurich workshop on alcoholic chronic pancreatitis. Int J Pancreatol. 1998;23:81–2.

    CAS  PubMed  Google Scholar 

  • Andersen DK. Mechanisms and emerging treatments of the metabolic complications of chronic pancreatitis. Pancreas. 2007;35:1–15.

    Article  CAS  PubMed  Google Scholar 

  • Andersen DK. The practical importance of recognizing pancreatogenic or type 3c diabetes. Diabetes Metab Res Rev. 2012;28:326–8.

    Article  PubMed  Google Scholar 

  • Andersen DK, Andren-Sandberg A, Duell EJ, et al. Pancreatitis-diabetes-pancreatic cancer: summary of an NIDDK-NCI workshop. Pancreas. 2013;42:1227–37.

    Article  CAS  PubMed  Google Scholar 

  • Arvanitakis M, Van Laethem JL, Parma J, et al. Predictive factors for pancreatic cancer in patients with chronic pancreatitis in association with K-ras gene mutation. Endoscopy. 2004;36:535–42.

    Article  CAS  PubMed  Google Scholar 

  • Axon AT, Classen M, Cotton PB, Cremer M, Freeny PC, Lees WR. Pancreatography in chronic pancreatitis: international definitions. Gut. 1984;25:1107–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP. 2006;7:390–6.

    PubMed  Google Scholar 

  • Balci NC, Smith A, Momtahen AJ, et al. MRI and S-MRCP findings in patients with suspected chronic pancreatitis: correlation with endoscopic pancreatic function testing (ePFT). J Magn Reson Imaging. 2010;31:601–6.

    Article  PubMed  Google Scholar 

  • Bhutani MS, Arantes VN, Verma D, et al. Histopathologic correlation of endoscopic ultrasound findings of chronic pancreatitis in human autopsies. Pancreas. 2009;38:820–4.

    Article  PubMed  Google Scholar 

  • Bian Y, Wang L, Chen C, et al. Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP. World J Gastroenterol: WJG. 2013;19(41):7177–7182. PMID: 24222963. doi:10.3748/wjg.v19.i41.7177.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bian Y, Wang L, Chen C, et al. Combination of secretin-enhanced MR cholangiopancreatography and conventional MRI in the diagnosis of chronic pancreatitis. Chin J Radiol. 2014;48(4):294–8.

    Google Scholar 

  • Bilgin M, Bilgin S, Balci NC, et al. Magnetic resonance imaging and magnetic resonance cholangiopancreatography findings compared with fecal elastase 1 measurement for the diagnosis of chronic pancreatitis. Pancreas. 2008;36:e33–9.

    Article  PubMed  Google Scholar 

  • Bolan PJ, Fink AS. Endoscopic retrograde cholangiopancreatography in chronic pancreatitis. World J Surg. 2003;27(11):1183–1191. PMID: 14716502. doi:10.1007/s00268-003-7236-9.

    Article  PubMed  Google Scholar 

  • Boninsegna E, Manfredi R, Ventriglia A, et al. Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy. Eur Radiol. 2015;25(8):2437–2444. PMID: 25693665. doi:10.1007/s00330-015-3644-0.

    Article  PubMed  Google Scholar 

  • Braganza JM, Lee SH, McCloy RF, McMahon MJ. Chronic pancreatitis. Lancet. 2011;377(9772):1184–97.

    Article  CAS  PubMed  Google Scholar 

  • Brugge WR. Endoscopic approach to the diagnosis and treatment of pancreatic disease. Curr Opin Gastroenterol. 2013;29:559–65.

    Article  PubMed  Google Scholar 

  • Buchler MW, Martignoni ME, Friess H, et al. A proposal for a new clinical classification of chronic pancreatitis. BMC Gastroenterol. 2009;9:93.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buxbaum J. The role of endoscopic retrograde cholangiopancreatography in patients with pancreatic disease. Gastroenterol Clin North Am. 2012;41:23–45.

    Article  PubMed  Google Scholar 

  • Carriere F, Laugier R, Barrowman JA, et al. Gastric and pancreatic lipase levels during a test meal in dogs. Scand J Gastroenterol. 1993;28:443–54.

    Article  CAS  PubMed  Google Scholar 

  • Catalano MF, Lahoti S, Geenen JE, Hogan WJ. Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis. Gastrointest Endosc. 1998;48:11–7.

    Article  CAS  PubMed  Google Scholar 

  • Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69:1251–61.

    Article  PubMed  Google Scholar 

  • Ceyhan GO, Bergmann F, Kadihasanoglu M, et al. The neurotropic factor artemin influences the extent of neural damage and growth in chronic pancreatitis. Gut. 2007;56(4):534–44.

    Article  CAS  PubMed  Google Scholar 

  • Chang KJ, Nguyen P, Erickson RA, et al. The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointest Endosc. 1997;45(5):387–93. PMID: 9165320.

    Article  CAS  PubMed  Google Scholar 

  • Chari ST, Smyrk TC, Levy MJ, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006;4:1010–6.

    Article  PubMed  Google Scholar 

  • Chari ST, Kloeppel G, Zhang L, et al. Histopathologic and clinical subtypes of autoimmune pancreatitis: the Honolulu consensus document. Pancreas. 2010;39:549–54.

    Article  CAS  PubMed  Google Scholar 

  • Chen N, Unnikrishnan IR, Anjana RM, Mohan V, Pitchumoni CS. The complex exocrine-endocrine relationship and secondary diabetes in exocrine pancreatic disorders. J Clin Gastroenterol. 2011;45:850–61.

    Article  CAS  PubMed  Google Scholar 

  • Chong AK, Hawes RH, Hoffman BJ, et al. Diagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology. Gastrointest Endosc. 2007;65:808–14.

    Article  PubMed  Google Scholar 

  • Choueiri NE, Balci NC, Alkaade S, et al. Advanced imaging of chronic pancreatitis. Curr Gastroenterol Rep. 2010;12:114–20.

    Article  PubMed  Google Scholar 

  • Chowdhury RS, Forsmark CE. Review article: pancreatic function testing. Aliment Pharmacol Ther. 2003;17:733–50.

    Article  CAS  PubMed  Google Scholar 

  • Chowdhury R, Bhutani MS, Mishra G, et al. Comparative analysis of direct pancreatic function testing versus morphological assessment by endoscopic ultrasonography for the evaluation of chronic unexplained abdominal pain of presumed pancreatic origin. Pancreas. 2005;31:63–8.

    Article  PubMed  Google Scholar 

  • Church NI, Pereira SP, Deheragoda MG, et al. Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series. Am J Gastroenterol. 2007;102:2417–25.

    Article  CAS  PubMed  Google Scholar 

  • Clark CJ, Fino NF, Clark N, et al. Trends in the use of endoscopic retrograde cholangiopancreatography for the management of chronic pancreatitis in the United States. J Clin Gastroenterol. 2016;50(5):417–422. PMID: 26890329. doi:10.1097/MCG.0000000000000493.

    PubMed  PubMed Central  Google Scholar 

  • Conwell DL, Zuccaro G, Purich E, et al. Comparison of endoscopic ultrasound chronic pancreatitis criteria to the endoscopic secretin-stimulated pancreatic function test. Dig Dis Sci. 2007;52:1206–10.

    Article  PubMed  Google Scholar 

  • Conwell DL, Lee LS, Yadav D, et al. American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines. Pancreas. 2014;43:1143–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cremer M, Deviere J, Engelholm L. Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long-term follow-up after 7 years of experience. Gastrointest Endosc. 1989;35:1–9.

    Article  CAS  PubMed  Google Scholar 

  • Cui Y, Andersen DK. Pancreatogenic diabetes: special considerations for management. Pancreatology. 2011;11:279–94.

    Article  PubMed  Google Scholar 

  • Das A, Nguyen CC, Li F, et al. Digital image analysis of EUS images accurately differentiates pancreatic cancer from chronic pancreatitis and normal tissue. Gastrointest Endosc. 2008;67:861–7.

    Article  PubMed  Google Scholar 

  • Delhaye M, Van Steenbergen W, Cesmeli E, et al. Belgian consensus on chronic pancreatitis in adults and children: statements on diagnosis and nutritional, medical, and surgical treatment. Acta Gastroenterol Belg. 2014;77:47–65.

    PubMed  Google Scholar 

  • Devereaux CE, Binmoeller KF. Endoscopic retrograde cholangiopancreatography in the next millennium. Gastrointest Endosc Clin N Am. 2000;10:117–33.

    CAS  PubMed  Google Scholar 

  • DeWitt J, McGreevy K, LeBlanc J, et al. EUS-guided Trucut biopsy of suspected nonfocal chronic pancreatitis. Gastrointest Endosc. 2005;62:76–84.

    Article  PubMed  Google Scholar 

  • DiMagno MJ, DiMagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2010;26:490–8.

    Article  PubMed  Google Scholar 

  • Dimagno MJ, Dimagno EP. Chronic pancreatitis. Curr Opin Gastroenterol. 2011;27(5):452–9.

    Google Scholar 

  • DiMagno EP, Go VL, Summerskill WH. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med. 1973;288:813–5.

    Google Scholar 

  • DiMagno EP, Malagelada JR, Go VL. Relationship between alcoholism and pancreatic insufficiency. Ann N Y Acad Sci. 1975;252:200–7.

    Article  CAS  PubMed  Google Scholar 

  • Dominguez-Munoz JE, Iglesias-Garcia J, Vilarino-Insua M, et al. 13C-mixed triglyceride breath test to assess oral enzyme substitution therapy in patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2007;5:484–8.

    Article  CAS  PubMed  Google Scholar 

  • Dominguez-Munoz JE, Iglesias-Garcia J, Castineira Alvarino M, et al. EUS elastography to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis. Gastrointest Endosc. 2015;81:136–42.

    Article  PubMed  Google Scholar 

  • Drenes AM, Krarap AL, Detlefsen S, et al. Pain in chronic pancreatitis: the role of neuropathic pain mechanisms. Gut. 2008;57(11):1616–27.

    Article  CAS  Google Scholar 

  • Dumasy V, Delhaye M, Cotton F, et al. Fat malabsorption screening in chronic pancreatitis. Am J Gastroenterol. 2004;99:1350–4.

    Article  PubMed  Google Scholar 

  • Ebert R, Creutzfeldt W. Reversal of impaired GIP and insulin secretion in patients with pancreatogenic steatorrhea following enzyme substitution. Diabetologia. 1980;19:198–204.

    Article  CAS  PubMed  Google Scholar 

  • Eddes EH, Verkijk M, Gielkens HA, et al. Pancreatic polypeptide secretion in patients with chronic pancreatitis and after pancreatic surgery. Int J Pancreatol. 2001;29:173–80.

    Article  CAS  PubMed  Google Scholar 

  • Engjom T, Erchinger F, Tjora E, et al. Diagnostic accuracy of secretin-stimulated ultrasonography of the pancreas assessing exocrine pancreatic failure in cystic fibrosis and chronic pancreatitis. Scand J Gastroenterol. 2015;50:601–10.

    Article  PubMed  Google Scholar 

  • Erchinger F, Engjom T, Tjora E, et al. Quantification of pancreatic function using a clinically feasible short endoscopic secretin test. Pancreas. 2013;42:1101–6.

    Article  PubMed  Google Scholar 

  • Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120:682–707.

    Article  CAS  PubMed  Google Scholar 

  • Ewald N, Bretzel RG. Diabetes mellitus secondary to pancreatic diseases (Type 3c)—are we neglecting an important disease? Eur J Intern Med. 2013;24:203–6.

    Article  PubMed  Google Scholar 

  • Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s gastrointestinal and liver disease—2 volume set: pathophysiology, diagnosis, management. Philadelphia: Saunders; 2015.

    Google Scholar 

  • Forsmark CE. The diagnosis of chronic pancreatitis. Gastrointest Endosc. 2000;52(2):293–298. PMID: 10922118. doi:10.1067/mge.2000.106889.

    Article  CAS  PubMed  Google Scholar 

  • Forsmark CE. Pancreatitis and its complications. Totowa: Humana Press; 2005. doi:10.1385/1592598153. ISBN: 978-1-58829-179-0.

    Book  Google Scholar 

  • Forsmark CE. The early diagnosis of chronic pancreatitis. Clin Gastroenterol Hepatol. 2008;6:1291–3.

    Article  PubMed  Google Scholar 

  • Forsmark CE. Management of chronic pancreatitis. Gastroenterology. 2013;144:1282–91.

    Article  PubMed  Google Scholar 

  • Forsmark CE, Toskes PP. What does an abnormal pancreatogram mean? Gastrointest Endosc Clin N Am. 1995;5:105–23.

    CAS  PubMed  Google Scholar 

  • Frulloni L, Lunardi C, Simone R, et al. Identification of a novel antibody associated with autoimmune pancreatitis. N Engl J Med. 2009;361:2135–42.

    Article  CAS  PubMed  Google Scholar 

  • Frulloni L, Falconi M, Gabbrielli A, et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42(Suppl 6):S381–406.

    Article  PubMed  Google Scholar 

  • Gardner TB, Levy MJ. EUS diagnosis of chronic pancreatitis. Gastrointest Endosc. 2010;71:1280–9.

    Article  PubMed  Google Scholar 

  • Glaser B, Zoghlin G, Pienta K, Vinik AI. Pancreatic polypeptide response to secretin in obesity: effects of glucose intolerance. Horm Metab Res. 1988;20:288–92.

    Article  CAS  PubMed  Google Scholar 

  • Gooshe M, Abdolghaffari AH, Nikfar S, et al. Antioxidant therapy in acute, chronic and post-endoscopic retrograde cholangiopancreatography pancreatitis: an updated systematic review and meta-analysis. World J Gastroenterol: WJG. 2015;21(30):9189–9208. PMID: 26290647. doi:10.3748/wjg.v21.i30.9189.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gupta V, Toskes PP. Diagnosis and management of chronic pancreatitis. Postgrad Med J. 2005;81(958):491–497. PMID: 16085738. doi:10.1136/pgmj.2003.009761.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gupte AR, Forsmark CE. Chronic pancreatitis. Curr Opin Gastroenterol. 2014;30:500–5.

    Article  PubMed  Google Scholar 

  • Haaber AB, Rosenfalck AM, Hansen B, et al. Bone mineral metabolism, bone mineral density, and body composition in patients with chronic pancreatitis and pancreatic exocrine insufficiency. Int J Pancreatol. 2000;27:21–7.

    Google Scholar 

  • Hernandez LV, Catalano MF. EUS in the diagnosis of early-stage chronic pancreatitis. Best Pract Res Clin Gastroenterol. 2010;24:243–9.

    Article  PubMed  Google Scholar 

  • Hoffmeister A, Mayerle J, Beglinger C, et al. S3-Consensus guidelines on definition, etiology, diagnosis and medical, endoscopic and surgical management of chronic pancreatitis German Society of Digestive and Metabolic Diseases (DGVS). Z Gastroenterol. 2012;50:1176–224.

    Article  CAS  PubMed  Google Scholar 

  • Hollerbach S, Klamann A, Topalidis T, et al. Endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA) cytology for diagnosis of chronic pancreatitis. Endoscopy. 2001;33:824–31.

    Article  CAS  PubMed  Google Scholar 

  • Homma T, Harada H, Koizumi M. Diagnostic criteria for chronic pancreatitis by the Japan Pancreas Society. Pancreas. 1997;15:14–5.

    Google Scholar 

  • Iglesias-Garcia J, Vilarino-Insua M, Iglesias-Rey M, et al. Accuracy of the optimized 13C-mixed triglyceride breath test for the diagnosis of steatorrhea in clinical practice. Gastroenterology. 2003;124:1.

    Article  Google Scholar 

  • Iglesias-Garcia J, Abdulkader I, Larino-Noia J, et al. Histological evaluation of chronic pancreatitis by endoscopic ultrasound-guided fine needle biopsy. Gut. 2006;55:1661–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Iglesias-Garcia J, Dominguez-Munoz JE, Castineira-Alvarino M, et al. Quantitative elastography associated with endoscopic ultrasound for the diagnosis of chronic pancreatitis. Endoscopy. 2013;45:781–8.

    Article  PubMed  Google Scholar 

  • Ikeda M, Sato T, Morozumi A, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey, with special reference to main duct dilatation, cyst formation, and calcification. Pancreas. 1994;9:508–12.

    Article  CAS  PubMed  Google Scholar 

  • Irisawa A, Mishra G, Hernandez LV, et al. Quantitative analysis of endosonographic parenchymal echogenicity in patients with chronic pancreatitis. J Gastroenterol Hepatol. 2004;19:1199–205.

    Article  PubMed  Google Scholar 

  • Ito T, Otsuki M, Itoi T, et al. Pancreatic diabetes in a follow-up survey of chronic pancreatitis in Japan. J Gastroenterol. 2007;42:291–7.

    Article  PubMed  Google Scholar 

  • Ito T, Ishiguro H, Ohara H, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol. 2016;51:85–92.

    Article  CAS  PubMed  Google Scholar 

  • Janssen J, Schlorer E, Greiner L. EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions. Gastrointest Endosc. 2007;65:971–8.

    Article  PubMed  Google Scholar 

  • Kahl S, Malfertheiner P. The place of endoscopic ultrasound in the diagnosis of chronic pancreatitis. In: Dominguez-Munoz JE, editor. Clinical pancreatology for practising gastroenterologists and surgeons. Oxford: Blackwell Publishing; 2005. p. 246–52.

    Google Scholar 

  • Kalaitzakis E, Braden B, Trivedi P, et al. Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis: egg or hen? World J Gastroenterol: WJG. 2009;15(10):1273–5. PMID: 19291831

    Article  PubMed  PubMed Central  Google Scholar 

  • Kalvaria I, Labadarios D, Shephard GS, et al. Biochemical vitamin E deficiency in chronic pancreatitis. Int J Pancreatol. 1986;1:119–28.

    CAS  PubMed  Google Scholar 

  • Kamisawa T, Okazaki K, Kawa S, et al. Japanese consensus guidelines for management of autoimmune pancreatitis: III. Treatment and prognosis of AIP. J Gastroenterol. 2010;45:471–7.

    Article  CAS  PubMed  Google Scholar 

  • Katschinski M, Schirra J, Bross A, et al. Duodenal secretion and fecal excretion of pancreatic elastase-1 in healthy humans and patients with chronic pancreatitis. Pancreas. 1997;15:191–200.

    Article  CAS  PubMed  Google Scholar 

  • Keller J, Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(Suppl 6):1–28.

    Article  PubMed Central  CAS  Google Scholar 

  • Keller J, Layer P. Diagnosis of pancreatic exocrine insufficiency in chronic pancreatitis. Exocrine Pancreas Knowledge Base: Pancreapedia; 2015.

    Google Scholar 

  • Keller J, Aghdassi AA, Lerch MM, et al. Tests of pancreatic exocrine function—clinical significance in pancreatic and non-pancreatic disorders. Best Pract Res Clin Gastroenterol. 2009;23:425–39.

    Article  CAS  PubMed  Google Scholar 

  • Keller J, Bruckel S, Jahr C, et al. A modified 13C-mixed triglyceride breath test detects moderate pancreatic exocrine insufficiency. Pancreas. 2011;40:1201–5.

    Article  CAS  PubMed  Google Scholar 

  • Keller J, Meier V, Wolfram KU, et al. Sensitivity and specificity of an abbreviated (13)C-mixed triglyceride breath test for measurement of pancreatic exocrine function. United European Gastroenterol J. 2014a;2(4):288–294. PMID: 25083286. doi:10.1177/2050640614542496.

    Article  PubMed  PubMed Central  Google Scholar 

  • Keller J, Layer P, Brückel S, et al. 13C-Mixed triglyceride breath test for evaluation of pancreatic exocrine function in diabetes mellitus. Pancreas. 2014b;43:842–8.

    Article  PubMed  Google Scholar 

  • Keogan MT, Edelman RR. Technologic advances in abdominal MR imaging. Radiology. 2001;220(2):310–320. PMID: 11477231. doi:10.1148/radiology.220.2.r01au22310.

    Article  CAS  PubMed  Google Scholar 

  • Ketwaroo G, Brown A, Young B, et al. Defining the accuracy of secretin pancreatic function testing in patients with suspected early chronic pancreatitis. Am J Gastroenterol. 2013;108(8):1360–1366. PMID: 23711627. doi:10.1038/ajg.2013.148.

    Article  PubMed  PubMed Central  Google Scholar 

  • Knop FK, Vilsboll T, Hojberg PV, et al. Reduced incretin effect in type 2 diabetes: cause or consequence of the diabetic state? Diabetes. 2007;56:1951–9.

    Article  CAS  PubMed  Google Scholar 

  • Lankisch PG, Schreiber A, Otto J. Pancreolauryl test. Evaluation of a tubeless pancreatic function test in comparison with other indirect and direct tests for exocrine pancreatic function. Dig Dis Sci. 1983;28:490–3.

    Article  CAS  PubMed  Google Scholar 

  • Lankisch PG, Droge M, Hofses S, et al. Steatorrhoea: you cannot trust your eyes when it comes to diagnosis [letter] [see comments]. Lancet. 1996;347:1620–1.

    Article  CAS  PubMed  Google Scholar 

  • Lara I, Rodriguez RI, Orillac J. Magnetic resonance cholangiopancreatography: an advanced technique in the diagnosis of biliopancreatic diseases (the first experience in Panama). Rev Med Panama. 2001;26:22–7. PMID: 16161720.

    CAS  PubMed  Google Scholar 

  • Larsen S, Hilsted J, Tronier B, Worning H. Metabolic control and B cell function in patients with insulin-dependent diabetes mellitus secondary to chronic pancreatitis. Metabolism. 1987;36:964–7.

    Article  CAS  PubMed  Google Scholar 

  • Larsen S, Hilsted J, Tronier B, Worning H. Pancreatic hormone secretion in chronic pancreatitis without residual beta-cell function. Acta Endocrinol. 1988;118:357–64.

    CAS  PubMed  Google Scholar 

  • Layer P, Go VL, DiMagno EP. Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol. 1986;251:G475–80.

    CAS  PubMed  Google Scholar 

  • Layer P, Yamamoto H, Kalthoff L, et al. The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Gastroenterology. 1994;107:1481–7.

    Article  CAS  PubMed  Google Scholar 

  • Layer P, von der Ohe MR, Holst JJ, et al. Altered postprandial motility in chronic pancreatitis: role of malabsorption. Gastroenterology. 1997;112:1624–34.

    Article  CAS  PubMed  Google Scholar 

  • LeBlanc JK, Chen JH, Al-Haddad M, et al. Endoscopic ultrasound and histology in chronic pancreatitis: how are they associated? Pancreas. 2014;43:440–4.

    Article  PubMed  Google Scholar 

  • Levy MJ, Wiersema MJ. EUS-guided Trucut biopsy. Gastrointest Endosc. 2005;62:417–26.

    Article  PubMed  Google Scholar 

  • Lieb JG II, Draganov PV. Pancreatic function testing: here to stay for the 21st century. World J Gastroenterol. 2008;14:3149–58.

    Article  PubMed  Google Scholar 

  • Linde J, Nilsson LH, Barany FR. Diabetes and hypoglycemia in chronic pancreatitis. Scand J Gastroenterol. 1977;12:369–73.

    Article  CAS  PubMed  Google Scholar 

  • Löhr JM, Dominguez-Munoz E, Rosendahl J, et al. Evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). UEG J 2017;5(2):153–99.

    Google Scholar 

  • Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328(20):1433–1437. PMID: 8479461. doi:10.1056/NEJM199305203282001.

    Article  CAS  PubMed  Google Scholar 

  • Luaces-Regueira M, Iglesias-Garcia J, Lindkvist B, et al. Smoking as a risk factor for complications in chronic pancreatitis. Pancreas. 2014;43:275–80.

    Article  PubMed  Google Scholar 

  • Majumder S, Chari ST. Chronic pancreatitis. Lancet. 2016;387:1957–66.

    Article  PubMed  Google Scholar 

  • Mann ST, Stracke H, Lange U, et al. Alterations of bone mineral density and bone metabolism in patients with various grades of chronic pancreatitis. Metabolism. 2003a;52:579–85.

    Article  CAS  PubMed  Google Scholar 

  • Mann ST, Stracke H, Lange U, et al. Vitamin D3 in patients with various grades of chronic pancreatitis, according to morphological and functional criteria of the pancreas. Dig Dis Sci. 2003b;48:533–8.

    Article  CAS  PubMed  Google Scholar 

  • Mann ST, Mann V, Stracke H, et al. Fecal elastase 1 and vitamin D3 in patients with osteoporotic bone fractures. Eur J Med Res. 2008;13:68–72.

    CAS  PubMed  Google Scholar 

  • Martinez J, Abad-Gonzalez A, Aparicio JR, et al. The Spanish Pancreatic Club recommendations for the diagnosis and treatment of chronic pancreatitis: part 1 (diagnosis). Pancreatology. 2013;13:8–17.

    Article  CAS  PubMed  Google Scholar 

  • Mayerle J, Hoffmeister A, Werner J, et al. Chronic pancreatitis—definition, etiology, investigation and treatment. Dtsch Arztebl Int. 2013;110:387–93.

    PubMed  PubMed Central  Google Scholar 

  • Md PS, Md UN. Role of ERCP in patients with idiopathic recurrent acute pancreatitis. Curr Treat Options Gastroenterol. 2016;14(3):327–339. PMID: 27371265. doi:10.1007/s11938-016-0096-9.

    Article  PubMed  Google Scholar 

  • Meier JJ, Giese A. Diabetes associated with pancreatic diseases. Curr Opin Gastroenterol. 2015;31:400–6.

    Article  CAS  PubMed  Google Scholar 

  • Meier JJ, Nauck MA. Is the diminished incretin effect in type 2 diabetes just an epi-phenomenon of impaired beta-cell function? Diabetes. 2010;59:1117–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Meier JJ, Breuer TG, Bonadonna RC, et al. Pancreatic diabetes manifests when beta cell area declines by approximately 65% in humans. Diabetologia. 2012;55:1346–54.

    Article  CAS  PubMed  Google Scholar 

  • Mensel B, Messner P, Mayerle J, et al. Secretin-stimulated MRCP in volunteers: assessment of safety, duct visualization, and pancreatic exocrine function. AJR Am J Roentgenol. 2014a;202(1):102–108. PMID: 24370134. doi:10.2214/AJR.12.10271.

    Article  PubMed  Google Scholar 

  • Mensel B, Messner P, Mayerle J, et al. Secretin-stimulated MRCP in volunteers: assessment of safety, duct visualization, and pancreatic exocrine function. Am J Roentgenol. 2014b;202(1):102–108. PMID: WOS:000329113000031. doi:10.2214/ajr.12.10271.

    Article  Google Scholar 

  • Merkle EM, Baillie J. Exocrine pancreatic function: evaluation with MR imaging before and after secretin stimulation. Am J Gastroenterol. 2006;101(1):137–138. PMID: 16405546. doi:10.1111/j.1572-0241.2006.00400.x.

    Article  PubMed  Google Scholar 

  • Milosavljevic T, Kostic Milosavljevic M, Krstic M, et al. Classification of chronic pancreatitis. Dig Dis. 2010;28(2):330–333. PMID: 20814207. doi:10.1159/000319409.

    Article  PubMed  Google Scholar 

  • Morselli-Labate AM, Pezzilli R. Usefulness of serum IgG4 in the diagnosis and follow up of autoimmune pancreatitis: a systematic literature review and meta-analysis. J Gastroenterol Hepatol. 2009;24:15–36.

    Article  PubMed  Google Scholar 

  • Muniraj T, Aslanian HR, Farrell J, et al. Chronic pancreatitis, a comprehensive review and update. Part II: diagnosis, complications, and management. Dis Mon. 2015;61(1):5–37. PMID: 25681098. doi:10.1016/j.disamonth.2014.12.003.

    Article  PubMed  Google Scholar 

  • Nagai H, Ohtsubo K. Pancreatic lithiasis in the aged. Its clinicopathology and pathogenesis. Gastroenterology. 1984;86:331–8.

    CAS  PubMed  Google Scholar 

  • Nagar AB, Gorelick FS. Pancreatitis and its complications. New York: Human Press; 2005.

    Google Scholar 

  • Nattermann C, Goldschmidt A, Dancygier H. Endosonography in chronic pancreatitis-a comparison between endoscopic retrograde pancreatography and endoscopic ultrasonography. Endoscopy. 1993;25:565–70.

    Article  CAS  PubMed  Google Scholar 

  • Navaneethan U, Venkataraman J. Recent advancement in the pathogenesis of pain in chronic pancreatitis: the argument continues. Minerva Gastroenterol Dietol. 2010;56(1):55–63.

    CAS  PubMed  Google Scholar 

  • Nayar MK, Paranandi B, Dawwas MF, et al. Comparison of the diagnostic performance of 2 core biopsy needles for EUS-guided tissue acquisition from solid pancreatic lesions. Gastrointest Endosc. 2016;85(5):1017–1024. PMID: 27633157. doi:10.1016/j.gie.2016.08.048.

    Article  PubMed  Google Scholar 

  • Okazaki K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.

    Article  PubMed  PubMed Central  Google Scholar 

  • Okazaki K, Kawa S, Kamisawa T, et al. Japanese clinical guidelines for autoimmune pancreatitis. Pancreas. 2009;38:849–66.

    Article  PubMed  Google Scholar 

  • Okazaki K, Kawa S, Kamisawa T, et al. Japanese consensus guidelines for management of autoimmune pancreatitis: I. Concept and diagnosis of autoimmune pancreatitis. J Gastroenterol. 2010;45:249–65.

    Article  PubMed  Google Scholar 

  • Otsuki M, Chung JB, Okazaki K, et al. Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune Pancreatitis. J Gastroenterol. 2008;43:403–8.

    Article  CAS  PubMed  Google Scholar 

  • Park WG, Van Dam J. Election year fever? Voting on EUS criteria for chronic pancreatitis. Gastrointest Endosc. 2009;69:1262–3.

    Article  PubMed  Google Scholar 

  • Parsi MA, Conwell DL, Zuccaro G, et al. Findings on endoscopic retrograde cholangiopancreatography and pancreatic function test in suspected chronic pancreatitis and negative cross-sectional imaging. Clin Gastroenterol Hepatol. 2008;6:1432–6.

    Article  PubMed  Google Scholar 

  • Paulo JA, Lee LS, Wu B, et al. Mass spectrometry-based proteomics of endoscopically collected pancreatic fluid in chronic pancreatitis research. Proteomics Clin Appl. 2011;5:109–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pezzilli R. Chronic pancreatitis: maldigestion, intestinal ecology and intestinal inflammation. World J Gastroenterol. 2009;15(14):1673–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pitchumoni CS. Chronic pancreatitis: pathogenesis and management of pain. J Clin Gastroenterol. 1998;27:101–7.

    Article  CAS  PubMed  Google Scholar 

  • Rabiee A, Galiatsatos P, Salas-Carrillo R, Thompson MJ, Andersen DK, Elahi D. Pancreatic polypeptide administration enhances insulin sensitivity and reduces the insulin requirement of patients on insulin pump therapy. J Diabetes Sci Technol. 2011;5:1521–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Raimondo M, Wallace MB. Diagnosis of early chronic pancreatitis by endoscopic ultrasound. Are we there yet? JOP. 2004;5:1–7.

    PubMed  Google Scholar 

  • Raina A, Yadav D, Krasinskas AM, et al. Evaluation and management of autoimmune pancreatitis: experience at a large US center. Am J Gastroenterol. 2009;104:2295–306.

    Article  PubMed  Google Scholar 

  • Rajan E, Clain JE, Levy MJ, et al. Age-related changes in the pancreas identified by EUS: a prospective evaluation. Gastrointest Endosc. 2005;61:401–6.

    Article  PubMed  Google Scholar 

  • Ramesh H. Proposal for a new grading system for chronic pancreatitis: the ABC system. J Clin Gastroenterol. 2002;35:67–70.

    Article  CAS  PubMed  Google Scholar 

  • Rebours V, Vullierme MP, Hentic O, et al. Smoking and the course of recurrent acute and chronic alcoholic pancreatitis: a dose-dependent relationship. Pancreas. 2012;41:1219–24.

    Article  CAS  PubMed  Google Scholar 

  • Rickels MR, Bellin M, Toledo FG, et al. Detection, evaluation and treatment of diabetes mellitus in chronic pancreatitis: recommendations from PancreasFest 2012. Pancreatology. 2013;13:336–42.

    Article  CAS  PubMed  Google Scholar 

  • Rosch T, Schusdziarra V, Born P, et al. Modern imaging methods versus clinical assessment in the evaluation of hospital in-patients with suspected pancreatic disease. Am J Gastroenterol. 2000;95(9):2261–2270. PMID: 11007227. doi:10.1111/j.1572-0241.2000.02312.x.

    Article  CAS  PubMed  Google Scholar 

  • Ross SO, Forsmark CE. Pancreatic and biliary disorders in the elderly. Gastroenterol Clin North Am. 2001;30:531–45.

    Article  CAS  PubMed  Google Scholar 

  • Roth CG. Fundamentals of body MRI. Philadelphia: Saunders; 2012. p. 135. ISBN: 978-1-4160-5183-1.

    Google Scholar 

  • Safari MT, Miri MB, Ebadi S, et al. Comparing the roles of EUS, ERCP and MRCP in idiopathic acute recurrent pancreatitis. Clin Med Insights Gastroenterol. 2016;9:35–39. PMID: 27375362. doi:10.4137/CGast.S37927.

    Article  PubMed  PubMed Central  Google Scholar 

  • Safdi M, Bekal PK, Martin S, et al. The effects of oral pancreatic enzymes (Creon 10 capsule) on steatorrhea: a multicenter, placebo-controlled, parallel group trial in subjects with chronic pancreatitis. Pancreas. 2006;33:156–62.

    Article  CAS  PubMed  Google Scholar 

  • Saftoiu A, Dietrich CF, Vilmann P. Contrast-enhanced harmonic endoscopic ultrasound. Endoscopy. 2012;44:612–7.

    Article  CAS  PubMed  Google Scholar 

  • Saftoiu A, Vilmann P, Dietrich CF, et al. Quantitative contrast-enhanced harmonic EUS in differential diagnosis of focal pancreatic masses (with videos). Gastrointest Endosc. 2015;82:59–69.

    Article  PubMed  Google Scholar 

  • Sahai AV, Zimmermann M, Aabakken L, Tarnasky PR, Cunningham JT, Van Velse A, et al. Prospective evaluation of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholagiopancreatography. Gastrointest Endosc. 1998;48:18–25.

    Article  CAS  PubMed  Google Scholar 

  • Sai JK, Suyama M, Kubokawa Y, et al. Diagnosis of mild chronic pancreatitis (Cambridge classification): comparative study using secretin injection-magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography. World J Gastroenterol: WJG. 2008;14(8):1218–21. PMID: 18300347.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sandrasegaran K, Cote GA, Tahir B, et al. The utility of secretin-enhanced MRCP in diagnosing congenital anomalies. Abdom Imaging. 2014;39(5):979–987. PMID: 24748158. doi:10.1007/s00261-014-0131-z.

    Article  PubMed  Google Scholar 

  • Sarles H. Proposal adopted unanimously by the participants of the Symposium, Marseilles 1963. Bibl Gastroenterol. 1965;7:7–8.

    Google Scholar 

  • Sarles H, Adler G, Dani R, et al. The pancreatitis classification of Marseilles-Rome 1988. Scand J Gastroenterol. 1989;24:641–2.

    Article  CAS  PubMed  Google Scholar 

  • Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984a;25:756–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sarner M, Cotton PB. Definitions of acute and chronic pancreatitis. Clin Gastroenterol. 1984b;13:865–70.

    CAS  PubMed  Google Scholar 

  • Schneider A, Hammerstingl R, Heller M, et al. Does secretin-stimulated MRCP predict exocrine pancreatic insufficiency?: a comparison with noninvasive exocrine pancreatic function tests. J Clin Gastroenterol. 2006;40:851–5.

    Article  CAS  PubMed  Google Scholar 

  • Schneider A, Lohr JM, Singer MV. The M-ANNHEIM classification of chronic pancreatitis: introduction of a unifying classification system based on a review of previous classifications of the disease. J Gastroenterol. 2007;42:101–19.

    Article  PubMed  Google Scholar 

  • Schreyer AG, Jung M, Riemann JF, et al. S3 Guideline for chronic pancreatitis—diagnosis, classification and therapy for the radiologist. Rofo. 2014;186:1002–8.

    Article  PubMed  Google Scholar 

  • Seicean A. Endoscopic ultrasound in chronic pancreatitis: where are we now? World J Gastroenterol. 2010;16:4253–63.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sey MS, Al-Haddad M, Imperiale TF, et al. EUS-guided liver biopsy for parenchymal disease: a comparison of diagnostic yield between two core biopsy needles. Gastrointest Endosc. 2016;83(2):347–352. PMID: 26278654. doi:10.1016/j.gie.2015.08.012.

    Article  PubMed  Google Scholar 

  • Shamamian P, Kingman P, Mallen-St J. Imaging of the pancreas: acute and chronic pancreatitis. Berlin: Springer; 2009.

    Google Scholar 

  • Sherman S, Freeman ML, Tarnasky PR, et al. Secretin (RG1068) Administration increases sensitivity of detection of duct abnormalities by magnetic resonance cholangiopancreatography in patients with pancreatitis. Gastroenterology. 2014. doi: 10.1053/j.gastro.2014.05.035. PMID: 24906040.

  • Shimosegawa T, Kataoka K, Kamisawa T, et al. The revised Japanese clinical diagnostic criteria for chronic pancreatitis. J Gastroenterol. 2010;45:584–91.

    Article  PubMed  Google Scholar 

  • Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011;40:352–8.

    Article  PubMed  Google Scholar 

  • Siegmund E, Löhr JM, Schuff-Werner P. Die diagnostische Validität nichtinvasiver Pankreasfunktionstests-eine Metaanalyse. Z Gastroenterol. 2004;42:1117–28.

    Article  CAS  PubMed  Google Scholar 

  • Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis. Report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France, March 28–30, 1984. Gastroenterology. 1985;89:683–5.

    Article  CAS  PubMed  Google Scholar 

  • Song TJ, Kim MH, Moon SH, et al. The combined measurement of total serum IgG and IgG4 may increase diagnostic sensitivity for autoimmune pancreatitis without sacrificing specificity, compared with IgG4 alone. Am J Gastroenterol. 2010;105(7):1655–60.

    Article  CAS  PubMed  Google Scholar 

  • Stabile Ianora AA, Rubini G, Lorusso F, et al. Chronic pancreatitis: which is the role of 320-row CT for the staging? Recenti Prog Med. 2013;104(7–8):381–386. PMID: 24042412. doi:10.1701/1315.14580.

    PubMed  Google Scholar 

  • Steer ML, Waxman I, Freedman S. Chronic pancreatitis. N Engl J Med. 1995;332(22):1482–90.

    Article  CAS  PubMed  Google Scholar 

  • Stevens T. Update on the role of endoscopic ultrasound in chronic pancreatitis. Curr Gastroenterol Rep. 2011;13:117–22.

    Article  PubMed  Google Scholar 

  • Stevens T. Role of endoscopic ultrasonography in the diagnosis of acute and chronic pancreatitis. Gastrointest Endosc Clin N Am. 2013;23(4):735–747. PMID: 24079787. doi:10.1016/j.giec.2013.06.001.

    Article  PubMed  Google Scholar 

  • Stevens T, Parsi MA. Endoscopic ultrasound for the diagnosis of chronic pancreatitis. World J Gastroenterol. 2010;16:2841–50.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stevens T, Parsi MA. Update on endoscopic pancreatic function testing. World J Gastroenterol. 2011;17:3957–61.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stevens T, Conwell DL, Zuccaro G Jr, et al. A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis. Gastrointest Endosc. 2008;67:458–66.

    Article  PubMed  Google Scholar 

  • Sugumar A, Levy MJ, Kamisawa T, et al. Endoscopic retrograde pancreatography criteria to diagnose autoimmune pancreatitis: an international multicentre study. Gut. 2011;60:666–70.

    Article  PubMed  Google Scholar 

  • Sze KC, Pirola RC, Apte MV, Wilson JS. Current options for the diagnosis of chronic pancreatitis. Expert Rev Mol Diagn. 2014a;14:199–215.

    Article  CAS  PubMed  Google Scholar 

  • Talamini G, Bassi C, Falconi M, et al. Early detection of pancreatic cancer following the diagnosis of chronic pancreatitis. Digestion. 1999;60(6):554–61. PMID: 10545726. doi: 7706.

    Article  CAS  PubMed  Google Scholar 

  • Talamini G, Zamboni G, Salvia R, et al. Intraductal papillary mucinous neoplasms and chronic pancreatitis. Pancreatology. 2006;6(6):626–634. PMID: 17135772. doi:10.1159/000097605.

    Article  PubMed  Google Scholar 

  • Tandon RK, Sato N, Garg PK, et al. Chronic pancreatitis: Asia-Pacific consensus report. J Gastroenterol Hepatol. 2002;17:508–18.

    Article  PubMed  Google Scholar 

  • Teichmann J, Mann ST, Stracke H, et al. Alterations of vitamin D3 metabolism in young women with various grades of chronic pancreatitis. Eur J Med Res. 2007;12:347–50.

    CAS  PubMed  Google Scholar 

  • Tetsuo H, Masaru K, Yutaka A, et al. Diagnostic criteria for autoimmune pancreatitis by the Japan pancreas society. J Jpn Pancreas Soc. 2002;17:585–7.

    Google Scholar 

  • Teuscher AU, Kendall DM, Smets YF, Leone JP, Sutherland DE, Robertson RP. Successful islet autotransplantation in humans: functional insulin secretory reserve as an estimate of surviving islet cell mass. Diabetes. 1998;47:324–30.

    Article  CAS  PubMed  Google Scholar 

  • Uhl W, Malfertheiner P, Sarr MG. Diseases of the pancreas: acute pancreatitis, chronic pancreatitis, neoplasms of the pancreas. Basel: Karger; 2004.

    Google Scholar 

  • Vantrappen GR, Rutgeerts PJ, Ghoos YF, et al. Mixed triglyceride breath test: a noninvasive test of pancreatic lipase activity in the duodenum. Gastroenterology. 1989;96:1126–34.

    Article  CAS  PubMed  Google Scholar 

  • Varadarajulu S, Eltoum I, Tamhane A, et al. Histopathologic correlates of noncalcific chronic pancreatitis by EUS: a prospective tissue characterization study. Gastrointest Endosc. 2007;66:501–9.

    Article  PubMed  Google Scholar 

  • Vardanyan M, Rilo HL. Pathogenesis of chronic pancreatitis-induced pain. Discov Med. 2010;9(47):304–10.

    PubMed  Google Scholar 

  • Vitale GC, Davis BR, Zavaleta C, et al. Endoscopic retrograde cholangiopancreatography and histopathology correlation for chronic pancreatitis. Am Surg. 2009;75(8):649–53. Discussion 653. PMID: 19725285.

    PubMed  Google Scholar 

  • Wang W, Liao Z, Li ZS, et al. Chronic pancreatitis in Chinese children: etiology, clinical presentation and imaging diagnosis. J Gastroenterol Hepatol. 2009a;24(12):1862–8.

    Article  PubMed  Google Scholar 

  • Wang LW, Li ZS, Li SD, et al. Prevalence and clinical features of chronic pancreatitis in China: a retrospective multicenter analysis over 10 years. Pancreas. 2009b;38:248–54.

    Article  CAS  PubMed  Google Scholar 

  • Warshaw AL, Banks PA, Fernández-Del CC. AGA technical review: treatment of pain in chronic pancreatitis. Gastroenterology. 1998;115:765–76.

    Article  CAS  PubMed  Google Scholar 

  • Wathle GK, Tjora E, Ersland L, et al. Assessment of exocrine pancreatic function by secretin-stimulated magnetic resonance cholangiopancreaticography and diffusion-weighted imaging in healthy controls. J Magn Reson Imaging. 2014;39(2):448–454. PMID: 23649590. doi:10.1002/jmri.24167.

    Article  PubMed  Google Scholar 

  • Whitcomb DC, Frulloni L, Garg P, et al. Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016;16:218–24.

    Article  PubMed  Google Scholar 

  • Wiersema MJ, Hawes RH, Lehmann GA, Kochmann ML, Sherman S, Kopecky KK. Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy. 1993;25:555–64.

    Article  CAS  PubMed  Google Scholar 

  • Yamada. Textbook of gastroenterology. Hoboken: Wiley-Blackwell; 2008.

    Book  Google Scholar 

  • Zhu M, Xu C, Yu J, et al. Differentiation of pancreatic cancer and chronic pancreatitis using computer-aided diagnosis of endoscopic ultrasound (EUS) images: a diagnostic test. PLoS One. 2013;8:e63820.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zhu J, Wang L, Chu Y, et al. A new descriptor for computer-aided diagnosis of EUS imaging to distinguish autoimmune pancreatitis from chronic pancreatitis. Gastrointest Endosc. 2015;82:831–6.e831.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. **n-Ying Tang, An-**g Zhao, and ** Yu contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China

    **n-Ying Tang M.D., An-**g Zhao M.D., ** Yu M.D., **-Huan Lin M.D., Wen-Bin Zou M.D., Zhuan Liao M.D., Zhao-Shen Li M.D., Liang-Hao Hu M.D., Lei **n M.D., Jian-Wei Zhu M.D., Fei Jiang M.D. & Zhen-Dong ** M.D.

  2. Shanghai Institute of Pancreatic Diseases, Shanghai, China

    **n-Ying Tang M.D., An-**g Zhao M.D., ** Yu M.D., **-Huan Lin M.D., Wen-Bin Zou M.D., Zhuan Liao M.D., Zhao-Shen Li M.D., Liang-Hao Hu M.D. & Lei **n M.D.

  3. Tibet Military General Hospital, Tibet, China

    ** Yu M.D.

  4. Department of Gastroenterology, The 307 Hospital of Academy of Military Medical Science, Bei**g, 100171, China

    Song Su M.D.

  5. Department of Internal Medicine, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

    Song Su M.D. & Mao-** Xu M.D.

  6. Department of Internal Medicine, Israelitic Hospital, Orchideenstieg 14, 22297, Hamburg, Germany

    Jutta Keller M.D. & Peter Layer

  7. Department of Radiology, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, China

    Yun Bian M.D., Ph.D., Jian-** Lu M.D. & Li Wang M.D.

  8. Department of Radiology, The 411st Hospital of Chinese PLA, Shanghai, 200081, China

    Yun Bian M.D., Ph.D.

Authors
  1. **n-Ying Tang M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. An-**g Zhao M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. ** Yu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. **-Huan Lin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wen-Bin Zou M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhuan Liao M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zhao-Shen Li M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Song Su M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mao-** Xu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jutta Keller M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Peter Layer
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yun Bian M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Jian-** Lu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Li Wang M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Liang-Hao Hu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Lei **n M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Jian-Wei Zhu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Fei Jiang M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Zhen-Dong ** M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Zhuan Liao M.D. , Zhao-Shen Li M.D. , Mao-** Xu M.D. , Jutta Keller M.D. , Li Wang M.D. , Zhen-Dong ** M.D. , Zhuan Liao M.D. , Zhao-Shen Li M.D. , Mao-** Xu M.D. , Jutta Keller M.D. , Li Wang M.D. , Zhuan Liao M.D. , Zhao-Shen Li M.D. or Zhen-Dong ** M.D. .

Editor information

Editors and Affiliations

  1. Department of Gastroenterology, Changhai Hospital, Shanghai, China

    Zhao-Shen Li

  2. Changhai Hospital, Department of Gastroenterology, Shanghai, China

    Zhuan Liao

  3. INSERM, Brest, France

    Jian-Min Chen

  4. INSERM UMR 1078, Brest, France

    Claude Férec

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Nature Singapore Pte Ltd. and Shanghai Scientific and Technical Publishers

About this chapter

Cite this chapter

Tang, XY. et al. (2017). Diagnosis of Chronic Pancreatitis. In: Li, ZS., Liao, Z., Chen, JM., Férec, C. (eds) Chronic Pancreatitis. Springer, Singapore. https://doi.org/10.1007/978-981-10-4515-8_7

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-4515-8_7

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-4513-4

  • Online ISBN: 978-981-10-4515-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation