Chronic Pancreatitis In Yunnan Province:Etiology, Diagnosis And Treatment

AIM:To investigate the etiology, diagnosis and treatment of chronic pancreatitis in Yunnan Province.METHODS:430patients with confirmed chronic pancreatitis in6provincial and municipal general hospitals of Yunnan Province between eight years (2003-01-01/2010-12-31) were retrospectively studied, including investigating their associated etiological factors, diagnostic and therapeutic methods.RESULTS:1, In Yunnan province, CP is more common in middle-aged men, male:female is2.9:1. Males with40-50ages is the most (28.8%), followed by30-40(20.6%),50-60(17.2%). Women with50-60ages is the most (20.9%), followed by over70years of age (16.4%),10-20(15.5%).2,In430cases of CP patients, the patients of50.5%had a history of smoking. Suffering from biliary diseases accounted for37.2%and42.1%of drinkers,29.5%of pancreatic stone disease,22.8%of acute pancreatitis,30.2%of abdominal surgery,66.0%of multiple pathogenic factors. Before and after four years, the ratio of patients with CP was1:1.59and suffering from biliary diseases and drinkers were accounted for39.8%,36.1%;35.6%,45.8%. In male patients, alcohol is the main pathogenic factor accounting for56.3%, and in females biliary diseases is the main pathogenic factor accounting for32.7%.3,CP is easy to recur, abdominal pain is the most important and the most common symptoms, accounted for93.3%; followed by weight loss (29.1%) and abdominal distension (13.5%).199(46.3%) CP patients developed complications, and187(43.5%) cases complicated pancreatic pseudocysts. Successfully followed-up 154cases, of which6.5%patients appeared cancerous.4,430cases of CP patients done no pancreatic exocrine function examination and the majority of pancreatic endocrine function test. In the imaging examination, positive rate of CT,MRI,MRCP is higher, they were96.9%,96.1%,94.4%; their sensitivity is higher, they were96.3%,96.2%,96.1%.5,In430cases of CP patients, the patients of medical treatment accounted for80.5%, in which using the antacid take the most (89.9%), using the pancreatic enzyme preparation take second place (33.8%); Surgical treatment for40.5%, in which adopting pancreatic bowel anastomosis take the most (69.2%); Endoscopic intervention is few (4.4%).CONCLUSION:In Yunnan Province, CP patients showed a trend of increase year by year, the prevalence rate is0.32-0.34%o. CP is more common in middle-aged men and40-50ages are the most, male:female is2.9:1. More than50%of the CP patients have a smoking history, biliary disease and alcohol factor are the main factors of CP. In recent years, alcohol has replaced biliary diseases become the CP first etiological factor. Pancreatic stone disease, acute pancreatitis, abdominal surgery has also a large proportion, More than half of patients suffer from multiple pathogenic factors. Abdominal pain is the most important and the most common symptoms, followed by weight loss, abdominal distension. CP complication rate is high, mainly with pancreatic pseudocysts. In the diagnosis and treatment of CP, Yunnan Province does not begin pancreatic exocrine function examination and the majority of pancreatic endocrine function test,at present, diagnosis of CP mainly depends on the symptoms and radiographic examination.For the patients with CP in Yunnan Province, positive rate and sensitivity of CT,MRI,,MRCP are higher, can be used as the first choice of CP imaging diagnosis. At present treatment of CP is still medical treatment to give priority to, surgical treatment is the second smallest, and endoscopic intervention is few. The vast majority of medical treatment use acid suppression, but pancreatin, octreotide and somatostatin's application scale is similar (30.3-33.8%). Pancreatic bowel anastomosis remains the main operation type of the surgical treatment. CP canceration rate is high, easy to recur, should pay attention to long term follow-up.