Aetiological risk factors are associated with distinct imaging findings in patients with chronic pancreatitis: A study of 959 cases from the Scandinavian Baltic Pancreatic Club (SBPC) imaging database

Trond Engjom*, Ingrid Kvåle Nordaas, Erling Tjora, Georg Dimcevski, Ingfrid Salvesen Haldorsen, Søren Schou Olesen, Asbjørn Mohr Drewes, Kristina Zviniene, Giedrus Barauskas, Hans Søe Riis Jespersen, Nanna Jensen, Anders Borch, Camilla Nøjgaard, Srdan Novovic, Svetlana S. Kardasheva, Alexey Okhlobystin, Truls Hauge, Anne Waage, Jens Brøndum Frøkjær

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Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstract

Objectives: The relation between aetiology and structural changes of the pancreas in patients with chronic pancreatitis (CP) is not fully understood. Earlier studies are limited by focusing on selected factors in studies of limited sample size. We aimed to use a large dataset to explore associations between aetiology and pancreatic morphology in CP. Methods: Subjects with definite or probable CP according to the M-ANNHEIM diagnostic criteria were included in this multicentre cross-sectional observational study and assessed using a standardized and validated CP imaging system. We performed multivariate logistic regression to analyse if aetiological factors adjusted for covariates were independently associated with morphological pancreatic features. Results: We included 959 patients (66% males). Mean (SD) age was 55 (14) years. Pancreatic structural changes were found in 94% of the subjects: 67% had calcifications, 59% main pancreatic duct dilatation, 33% pseudo-cysts and 22% pancreatic atrophy. Alcohol abuse was independently associated with pancreatic calcifications (odds ratio (OR, [95% CI]); 1.61, [1.09, 2.37]) and focal acute pancreatitis (OR; 2.13, [1.27, 3.56]), whereas smoking was independently associated with more severe calcifications (OR; 2.09, [1.34, 3.27]) and involvement of the whole gland (OR; 2.29, [1.61, 3.28]). Disease duration was positively associated with calcifications (OR; (per year) 1.05 [1.02, 1.08]) and pancreatic atrophy (OR; 1.05 [1.02, 1.08]) and negatively associated with focal acute pancreatitis (OR 0.91, [0.87, 0.95] and pseudo cysts (OR; 0.96, [0.93, 0.98]). Conclusion: In this large-scale study, etiological risk factors and disease duration in CP were independently associated with specific structural pancreatic imaging changes.

OriginalsprogEngelsk
TidsskriftPancreatology
Vol/bind21
Udgave nummer4
Sider (fra-til)688-697
Antal sider10
ISSN1424-3903
DOI
StatusUdgivet - jun. 2021

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