The Clinical Analysis Of138Chronic Pancreatitis Cases

Object:Retrospectively review and analyzing the various etiology, clinical characteristic, the relationship between etiology and the major complications and treatment of138cases of chronic pancreatitis patients in Xiangya hospital in the recently three years. Classification and stage of the CP patients according to the CP management guideline established by Association of Digestive Endoscopy, Chinese Society of Medicine(ADE, CSM). To improve the understanding of the disease and get further reference for the diagnosis and treatment of CP.Method:To retrospective analysis the clinical data of the138CP cases of Xiangya hospital from January2010to December2013. To compile statistics the causes of the disease, the clinical manifestation, the imaging texts, and analysis the relationship between the main etiologies and clinical manifestation. Classification the cases according to the ADE,CSM guideline, then assess the therapeutic effect of cases in nonoperative group and operative group.Result:1. The factor of chronic poisoning was the primary cause of the disease in these cases, which making up of44.2%. the secondary was smoking, which making up of42.8%. Biliary duct factor making up of20.2%. And other causes of disease included hyperlipidemia(39.9%), idiopathic CP (24.6%), Autoimmune pancreatitits (2.2%).2. The main clinical manifestation was abdominal pain the was116(85%) patients,56(40.5%) patients with radiating pain.30patients (21.7%) were lost weight.27(19.5) patients suffer from jaundice. There were30(21.7%) cases with blood glucose raised. And20(14.4) cases with pancreatic pseudocysts.3. In these cases the imaging text mainly were type B ultrasonic, CT and ERCP/MRCP, in which type B ultrasonic had137cases and the positive had103cases(75.1%). The CT had128cases and the positive cases had117(91.4%), the ERCP/MRCP had56cases and positive had52(92.9%). The positive rate of CT was obviously higher than type-B ultraconic(P<0.05).4. The pancreatic calcification incidence of patients with longtime alcohol consumption were significantly higher than that of non-drinking patients (55.7%Vs28.6)(P<0.05), and there was a significant between them; the diabetes incidence of the patients with longtime alcohol consumption were lower than that of non-drinking patients, but that was not significantly different. The pancreatic calcification incidence of smoking patients were significantly higher than that of non-smoking patients (54.2%Vs32.9)(P<0.05), and the incidence of diabetes were higher than non-smoking patients(23.7Vs10.1)(P<0.05), it was significantly different.5According to ADE, CSM guideline classified the chronic pancreatitis:11(8%) cases were in type I;58(42%) cases were in type II;47(34.0%) cases were in type Ⅲ,22(16%) cases were in type IV. Clinical staging of CP:69(60%) cases were in stage1;47(34%) cases were in stage2;22(16%) were in stage3.6. In these cases,71cases of surgical treatment accounted for51.4%. There were39cases of pancreatic duct decompress drainage,12 cases of pancreatectomy.20cases of biliary surgery and4cases of paunch to biopsy probe. The other67(48.5%) cases suffered conservative treatment. All cases were divided into two group with surgical treatment and the conservative treatment group. In the follow-up after discharge. Two weeks after treatment we had scored the stage I,2and3of cases respectively according to M-ANNHEIM score system, and found that the effect of surgical treatment was better than the one of conservative treatment in stage2, and the effect of conservative treatment was better than the on of surgical treatment in stage3.Conclusion:1. In recent3years, the major risky factors of CP in our hospital were alcohol, smoking, biliary system disease and hyperlipemia. And the alcohol had become the first risky factor.2. CP patients with longtime alcohol consumption had high incidence of pancreatic calcification than the non-drinking patients, CP patients with smoking had high incidence both of pancreatic calcification and diabetes than the non-smoking patients,3. The most common imaging text were type-B ultrasonic and GT in the diagnosis of the CP in our hospital, the positive of CT was obviously higher than the type-B ultrasonic.4. The effect of surgical treatment was better than conservative treatment for stage2, the effect of conservative treatment was better than surgical treatment for stage3.