• Journal of Digestive Cancer Research
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• v.12 no.2
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• pp.102-105
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• 2024

Chronic pancreatitis, a significant risk factor for pancreatic cancer, necessitates monitoring for pancreatic cancer development. Chronic pancreatitis can be broadly categorized into hereditary and sporadic. Given the variability in the risk for pancreatic cancer based on the presence and type of genetic mutations, it is crucial to establish and be aware of guidelines for screening and surveillance tailored to each risk level. In cases of hereditary chronic pancreatitis with PRSS1 mutations, patients demonstrated a high incidence of pancreatic cancer, justifying the rationale for screening and surveillance. However, the incidence of pancreatic cancer is relatively low in hereditary chronic pancreatitis with other genetic mutations and sporadic chronic pancreatitis; thus, precise screening and periodic surveillance are not recommended. For individuals with PRSS1 mutation-related hereditary chronic pancreatitis, surveillance may be considered from the age of 40 years. While computed tomography or magnetic resonance imaging is suitable for pancreatic cancer screening, endoscopic ultrasonography is not recommended because of parenchymal inflammation, fibrosis, and calcification. However, in cases of sporadic chronic pancreatitis where various risk factors for pancreatic cancer coexist, the incidence of pancreatic cancer significantly increases. Therefore, in 5 years after the diagnosis of chronic pancreatitis, the pancreatic cancer incidence has been observed to continuously increase. In such cases, individualized screening tests and surveillance based on the patient's symptoms and specific circumstances must be considered.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.256-260
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• 2001

Chronic pancreatitis is a rare problem in childhood and sometimes shows pancreatic calcification. The most common symptom is recurrent upper abdominal pain with or without associated nausea or vomiting. Pancreatic calcifications are virtually pathognomonic of chronic pancreatitis. In our case, however, chronic pancreatitis caused by multiple pancreatic stones in dilated pancreatic duct, which was very rare in childhood. Endoscopic retrograde cholangiopancreaticography (ERCP) is valuable in confirming the diagnosis and decision making process for further medical or surgical management of pancreatic disease. We experienced a case of chronic relapsing pancreatitis with pancreatic stones in 13-year-old girl who presented with recurrent upper abdominal pain. She was investigated with ERCP and treated by endoscopic sphincterotomy of sphincter of Oddi and by some stone removal with endoscopic basket. We report this case and review related literatures briefly.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.621-634
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• 2023

Objectives: This study summarizes current trends and results in clinical studies on herbal medicine treatments for chronic pancreatitis. Methods: Studies published from 2014 to 2023 were searched for on the China National Knowledge Infrastructure (CNKI), PubMed, and KMbase using the keywords "chronic pancreatitis", "herbal medicine", "herb", "만성 췌장염", and "한약". The studies were analyzed according to year, study design, characteristics of the patients, and traditional Chinese medicine (TCM) intervention. Results: In total, 23 studies were selected. There were 21 randomized controlled trials and 2 case-control studies. The most common herbal prescriptions were Qingyi-tang (淸胰湯), Radix Bupleuri (柴胡), Radix Paeoniae Alba (白芍藥), Radix Glycyrrhizae (甘草), Radix Scutellariae (黃芩), and Rhei Rhizoma (大黃). In all the studies, herbal medicine treatments were effective in the treatment of chronic pancreatitis, and efficacy was assessed using clinical symptoms, physicochemical examination, radiological examination, and relapse. Conclusions: Herbal medicine treatment can be an effective treatment for chronic pancreatitis and has potential in clinical practice.

• The Journal of Internal Korean Medicine
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• v.38 no.1
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• pp.48-63
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• 2017

Objectives: This study was performed to review the recent clinical research trends of the effects of herbal medicine treatment on chronic pancreatitis in China. Methods: We searched for clinical studies about chronic pancreatitis from the China Academic Journal (CAJ) of the China National Knowledge Infrastructure (CNKI) from January 1, 2005, to August 1, 2016. Results: Thirty-seven papers were selected from 126 studies. The most commonly used herbal prescriptions included Bupleuri Radix (柴胡), Paeoniae Radix Alba (白芍藥), Glycyrrhizae Radix (甘草), Scutellariae Radix (黃芩), Aucklandiae Radix (木香), and Rhei Rhizoma (大黃). Qingyi-tang (淸胰湯) was the most frequently used herbal prescription. Clinical symptoms, physicochemical examination, radiological examination, and relapse were used to evaluate the treatments. The effective treatment rate was 77.5-100%, and effectiveness in the experimental group was significantly higher than in the control group in 15 papers (p<0.05). Conclusions: Herbal medicine treatment has been shown as an effective treatment for chronic pancreatitis. In the future, more scientifically designed clinical studies should be performed to prove the effectiveness of herbal medicine treatment on chronic pancreatitis. These research results can be utilized in other clinical studies and in the treatment of chronic pancreatitis.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.204-209
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• 2022

The state of intense peripancreatic inflammation in chronic pancreatitis can give rise to various vascular complications such as venous thrombosis and arterial pseudoaneurysms. Due to its intimate location with the pancreas, spleno-mesenteric-portal axis suffers the greatest blunt of thrombotic complications. Treatment modalities for such cases of chronic portal vein thrombosis have always been controversial and challenging. Medical management with anticoagulants is both risky and unsatisfactory due to presence of varices, hypersplenism, and persistence of the inflammatory pathology. Although endovascular techniques have been tried in various case reports, there are definite anatomical challenges in cases of long segment porto-mesenteric thrombosis with massive ascites. Surgical shunts have been historically described for cirrhotic and non-cirrhotic portal hypertensive patients. However, its use in patients with refractory ascites due to chronic pancreatitis induced portal vein thrombosis has not been reported in the medical literature. Here, we present a case of an extensive portal vein thrombosis with massive refractory ascites in a patient with alcohol-induced chronic pancreatitis successfully treated with a surgical mesocaval shunt using an interposition small diameter graft.

• Journal of Acupuncture Research
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• v.24 no.3
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• pp.231-238
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• 2007

Objectives : The purpose of this case is to report the improvement after treatment on the patient who has chronic pancreatitis with pseudocyst. Methods: We treated the patient with oriental and western medical treatment from 22nd February 2007 to 24th March 2007. We checked the patient with VAS score and Abdomen CT. Results : After treatment Pain, dyspepsia, itching sense and general body weakness were improved, VAS score changed from 10 to 0 and cystic lesion decreased on Abdomen CT. Conclusion : This case shows oriental medical treatment has useful effect on chronic pancreatitis. More research of chronic pancreatitis is needed.

• CELLMED
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• v.7 no.2
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• pp.9.1-9.6
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• 2017

Recurrent Acute Pancreatitis/ Chronic Pancreatitis (RAP/ CP) is generally marked by sudden onset of symptoms like severe abdominal pain, vomiting and weight loss that needs emergency hospitalization. Owing to irreversible and progressive nature of the disease and limitations of conventional treatment, many patients look for an alternative solution. Here, we report data of 250 well diagnosed cases of acute recurring/ chronic pancreatitis, enrolled in between January 1997 to August 2016, in our Ayurvedic clinical practice in Northern part of India. Ayurveda is well recognized as an independent medical system parallel to conventional medicines in India and a subject is free to opt for any system of medicine for the prevention and treatment of any ailment. The subjects were treated with a complex herbo-mineral formulation based on the principles of Rasa Shastra in Ayurveda that deals with the therapeutics of processed metals in the prevention and treatment of diseases. They were also prescribed a regulated balanced diet and lifestyle. Significant improvement has been noted in subjects who have completed the treatment.

• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.227-230
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• 2013

Chronic pancreatitis is a progressive inflammatory disease resulting from repeated episodes of acute pancreatitis that impair exocrine function and eventually produce endocrine insufficiency. Some causes of chronic pancreatitis appear to be associated with alterations in the serine-protease inhibitor, Kazal type 1 (SPINK1), cationic trypsinogen (PRSS1), and cystic fibrosis-transmembrane conductance regulator (CFTR ) genes, or with structural disorders in the pancreaticobiliary ductal system, such as pancreatic divisum or anomalous pancreaticobiliary ductal union (APBDU). However, it is unusual to observe both genetic alteration and structural anomaly. Here, we report 2 cases with both APBDU and a mutation in the SPINK1 genes, and we discuss the implications of these findings in clinical practice.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.5029-5034
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• 2014

This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February $5^{th}$, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.