The interpretation of the American College of Gastroenterology clinical guideline on chronic pancreatitis and the comparison of related guidelines domestically and abroad_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Xueping ,  ZHU Liang

Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang 330006, P.R.China;

Corresponding author：

ZHU Liang, Email: 89493075@qq.com

Keywords：

Chronic pancreatitis; Guideline; Diagnosis; Etiology; Treatment

DOI：

10.7507/1672-2531.202003191

Video：

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In February 2020, the American College of Gastroenterology (ACG) published the latest guideline on chronic pancreatitis, and put forward practical recommendations on the etiology, natural history, diagnosis, treatment, prognosis and follow-up of chronic pancreatitis. This paper aims to provide references for the diagnosis and treatment of chronic pancreatitis in China by interpreting the main content of the guideline and comparing it with related guidelines or consensuses domestically and abroad.

Citation： YANG Xueping, ZHU Liang. The interpretation of the American College of Gastroenterology clinical guideline on chronic pancreatitis and the comparison of related guidelines domestically and abroad. Chinese Journal of Evidence-Based Medicine, 2020, 20(11): 1251-1256. doi: 10.7507/1672-2531.202003191 Copy

1.	Gardner TB, Adler DG, Forsmark CE, et al. ACG clinical guideline: chronic pancreatitis. Am J Gastroenterol, 2020, 115(3): 322-339.
2.	Whitcomb DC, Shimosegawa T, Chari ST, et al. International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club. Pancreatology, 2018, S1424-3903(18)30113-3.
3.	Issa Y, Kempeneers MA, van Santvoort HC, et al. Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis. Eur Radiol, 2017, 27(9): 3820-3844.
4.	中国医师协会胰腺病专业委员会慢性胰腺炎专委会, 海军军医大学附属长海医院消化内科, 黑龙江省医院消化内科, 等. 慢性胰腺炎诊治指南(2018, 广州). 中华胰腺病杂志, 2018, 18(5): 289-296.
5.	Frøkjær JB, Akisik F, Farooq A, et al. Guidelines for the diagnostic cross sectional imaging and severity scoring of chronic pancreatitis. Pancreatology, 2018, 18(7): 764-773.
6.	Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the rosemont classification. Gastrointest Endosc, 2009, 69(7): 1251-1261.
7.	Alpern MB, Sandler MA, Kellman GM, et al. Chronic pancreatitis: ultrasonic features. Radiology, 1985, 155(1): 215-219.
8.	Jones SN, Lees WR, Frost RA. Diagnosis and grading of chronic pancreatitis by morphological criteria derived by ultrasound and pancreatography. Clin Radiol, 1988, 39(1): 43-48.
9.	Manfredi R, Costamagna G, Brizi MG, et al. Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology, 2000, 214(3): 849-855.
10.	Bali MA, Sztantics A, Metens T, et al. Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial Results. Eur Radiol, 2005, 15(10): 2110-2121.
11.	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(3): 601-606.
12.	Manfredi R, Lucidi V, Gui B, et al. Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology, 2002, 224(3): 675-682.
13.	Cappeliez O, Delhaye M, Devière J, et al. Chronic pancreatitis: evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation. Radiology, 2000, 215(2): 358-364.
14.	Trikudanathan G, Vega-Peralta J, Malli A, et al. Diagnostic performance of endoscopic ultrasound (EUS) for non-calcific chronic pancreatitis (NCCP) based on histopathology. Am J Gastroenterol, 2016, 111(4): 568-574.
15.	Young MC, Theis JR, Hodges JS, et al. Preoperative computerized tomography and magnetic resonance imaging of the pancreas predicts pancreatic mass and functional outcomes after total pancreatectomy and islet autotransplant. Pancreas, 2016, 45(7): 961-966.
16.	Fritscher-Ravens A, Brand L, Knöfel WT, et al. Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis. Am J Gastroenterol, 2002, 97(11): 2768-2775.
17.	Whitcomb DC, North American Pancreas Study Group. Pancreatitis: TIGAR-O version 2 risk/etiology checklist with topic reviews, updates, and use primers. Clin Trans Gastroenterol 2019, 10(6): e00027.
18.	Schneider A, Löhr 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(2): 101-119.
19.	Whitcomb DC. Primer on precision medicine for complex chronic disorders. Clin Trans Gastroenterol, 2019, 10(7): e00067.
20.	Yadav D, O'Connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Am J Gastroenterol, 2012, 107(7): 1096-1103.
21.	Ito T, Ishiguro H, Ohara H, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol, 2016, 51(2): 85-92.
22.	Strum WB. Abstinence in alcoholic chronic pancreatitis: effect on pain and outcome. J Clin Gastroenterol, 1995, 20(1): 37-41.
23.	Yadav D, Whitcomb DC. The role of alcohol and smoking in pancreatitis. Nat Rev Gastroenterol Hepatol, 2010, 7(3): 131-145.
24.	Talamini G, Bassi C, Falconi M, et al. Smoking cessation at the clinical onset of chronic pancreatitis and risk of pancreatic calcifications. Pancreas, 2007, 35(4): 320-326.
25.	Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med, 2007, 356(7): 676-684.
26.	Dumonceau JM, Delhaye M, Tringali A, et al. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) guideline - updated August 2018. Endoscopy, 2019, 51(2): 179-193.
27.	Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology, 2009, 136(1): 149-159.
28.	Siriwardena AK, Mason JM, Sheen AJ, et al. Antioxidant therapy does not reduce pain in patients with chronic pancreatitis: the ANTICIPATE study. Gastroenterology, 2012, 143(3): 655-663.
29.	Shafiq N, Rana S, Bhasin D, et al. Pancreatic enzymes for chronic pancreatitis. Cochrane Database Syst Rev, 2009, (4): CD006302.
30.	Yaghoobi M, McNabb-Baltar J, Bijarchi R, et al. Pancreatic enzyme supplements are not effective for relieving abdominal pain in patients with chronic pancreatitis: meta-analysis and systematic review of randomized controlled trials. Can J Gastroenterol Hepatol, 2016, 2016: 8541839.
31.	Wyse JM, Battat R, Sun S, et al. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis. Endosc Ultrasound, 2017, 6(6): 369-375.
32.	Park W, Manickavasagan H, Kumar A. Efficacy of celiac plexus block in chronic pancreatitis-a systematic review. Gastrointest Endo, 2017, 85(5S): AB341-AB342.
33.	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.
34.	Shelton CA, Umapathy C, Stello K, et al. Hereditary pancreatitis in the United States: survival and rates of pancreatic cancer. Am J Gastroenterol, 2018, 113(9): 1376-1384.

1. Gardner TB, Adler DG, Forsmark CE, et al. ACG clinical guideline: chronic pancreatitis. Am J Gastroenterol, 2020, 115(3): 322-339.
2. Whitcomb DC, Shimosegawa T, Chari ST, et al. International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club. Pancreatology, 2018, S1424-3903(18)30113-3.
3. Issa Y, Kempeneers MA, van Santvoort HC, et al. Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis. Eur Radiol, 2017, 27(9): 3820-3844.
4. 中国医师协会胰腺病专业委员会慢性胰腺炎专委会, 海军军医大学附属长海医院消化内科, 黑龙江省医院消化内科, 等. 慢性胰腺炎诊治指南(2018, 广州). 中华胰腺病杂志, 2018, 18(5): 289-296.
5. Frøkjær JB, Akisik F, Farooq A, et al. Guidelines for the diagnostic cross sectional imaging and severity scoring of chronic pancreatitis. Pancreatology, 2018, 18(7): 764-773.
6. Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the rosemont classification. Gastrointest Endosc, 2009, 69(7): 1251-1261.
7. Alpern MB, Sandler MA, Kellman GM, et al. Chronic pancreatitis: ultrasonic features. Radiology, 1985, 155(1): 215-219.
8. Jones SN, Lees WR, Frost RA. Diagnosis and grading of chronic pancreatitis by morphological criteria derived by ultrasound and pancreatography. Clin Radiol, 1988, 39(1): 43-48.
9. Manfredi R, Costamagna G, Brizi MG, et al. Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology, 2000, 214(3): 849-855.
10. Bali MA, Sztantics A, Metens T, et al. Quantification of pancreatic exocrine function with secretin-enhanced magnetic resonance cholangiopancreatography: normal values and short-term effects of pancreatic duct drainage procedures in chronic pancreatitis. Initial Results. Eur Radiol, 2005, 15(10): 2110-2121.
11. 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(3): 601-606.
12. Manfredi R, Lucidi V, Gui B, et al. Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology, 2002, 224(3): 675-682.
13. Cappeliez O, Delhaye M, Devière J, et al. Chronic pancreatitis: evaluation of pancreatic exocrine function with MR pancreatography after secretin stimulation. Radiology, 2000, 215(2): 358-364.
14. Trikudanathan G, Vega-Peralta J, Malli A, et al. Diagnostic performance of endoscopic ultrasound (EUS) for non-calcific chronic pancreatitis (NCCP) based on histopathology. Am J Gastroenterol, 2016, 111(4): 568-574.
15. Young MC, Theis JR, Hodges JS, et al. Preoperative computerized tomography and magnetic resonance imaging of the pancreas predicts pancreatic mass and functional outcomes after total pancreatectomy and islet autotransplant. Pancreas, 2016, 45(7): 961-966.
16. Fritscher-Ravens A, Brand L, Knöfel WT, et al. Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis. Am J Gastroenterol, 2002, 97(11): 2768-2775.
17. Whitcomb DC, North American Pancreas Study Group. Pancreatitis: TIGAR-O version 2 risk/etiology checklist with topic reviews, updates, and use primers. Clin Trans Gastroenterol 2019, 10(6): e00027.
18. Schneider A, Löhr 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(2): 101-119.
19. Whitcomb DC. Primer on precision medicine for complex chronic disorders. Clin Trans Gastroenterol, 2019, 10(7): e00067.
20. Yadav D, O'Connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Am J Gastroenterol, 2012, 107(7): 1096-1103.
21. Ito T, Ishiguro H, Ohara H, et al. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. J Gastroenterol, 2016, 51(2): 85-92.
22. Strum WB. Abstinence in alcoholic chronic pancreatitis: effect on pain and outcome. J Clin Gastroenterol, 1995, 20(1): 37-41.
23. Yadav D, Whitcomb DC. The role of alcohol and smoking in pancreatitis. Nat Rev Gastroenterol Hepatol, 2010, 7(3): 131-145.
24. Talamini G, Bassi C, Falconi M, et al. Smoking cessation at the clinical onset of chronic pancreatitis and risk of pancreatic calcifications. Pancreas, 2007, 35(4): 320-326.
25. Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med, 2007, 356(7): 676-684.
26. Dumonceau JM, Delhaye M, Tringali A, et al. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) guideline - updated August 2018. Endoscopy, 2019, 51(2): 179-193.
27. Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology, 2009, 136(1): 149-159.
28. Siriwardena AK, Mason JM, Sheen AJ, et al. Antioxidant therapy does not reduce pain in patients with chronic pancreatitis: the ANTICIPATE study. Gastroenterology, 2012, 143(3): 655-663.
29. Shafiq N, Rana S, Bhasin D, et al. Pancreatic enzymes for chronic pancreatitis. Cochrane Database Syst Rev, 2009, (4): CD006302.
30. Yaghoobi M, McNabb-Baltar J, Bijarchi R, et al. Pancreatic enzyme supplements are not effective for relieving abdominal pain in patients with chronic pancreatitis: meta-analysis and systematic review of randomized controlled trials. Can J Gastroenterol Hepatol, 2016, 2016: 8541839.
31. Wyse JM, Battat R, Sun S, et al. Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis. Endosc Ultrasound, 2017, 6(6): 369-375.
32. Park W, Manickavasagan H, Kumar A. Efficacy of celiac plexus block in chronic pancreatitis-a systematic review. Gastrointest Endo, 2017, 85(5S): AB341-AB342.
33. 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.
34. Shelton CA, Umapathy C, Stello K, et al. Hereditary pancreatitis in the United States: survival and rates of pancreatic cancer. Am J Gastroenterol, 2018, 113(9): 1376-1384.

Chinese Journal of Evidence-Based Medicine

The interpretation of the American College of Gastroenterology clinical guideline on chronic pancreatitis and the comparison of related guidelines domestically and abroad

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