International Consensus Guidelines for Risk Factors in Chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club
Por:
Hegyi, P, Parniczky, A, Lerch, M, Sheel, A, Rebours, V, Forsmark, C, Del Chiaro, M, Rosendahl, J, De-Madaria, E, Szucs, A, Takaori, K, Yadav, D, Gheorghe, C, Rakonczay, Z, Molero, X, Inui, K, Masamune, A, Fernandez-Del Castillo, C, Shimosegawa, T, Neoptolemos, J, Whitcomb, D, Sahin-Toth, M and Working Grp Int IAP-APA-JPS-EPC
Publicada:
1 jun 2020
Ahead of Print:
8 abr 2020
Resumen:
Background: Chronic pancreatitis (CP) is a complex inflammatory disease with remarkably impaired quality of life and permanent damage of the pancreas. This paper is part of the international consensus guidelines on CP and presents the consensus on factors elevating the risk for CP.
Methods: An international working group with 20 experts on CP from the major pancreas societies (IAP, APA, JPS, and EPC) evaluated 14 statements generated from evidence on four questions deemed to be the most clinically relevant in CP. The Grading of Recommendations Assessment, Development, and Evalu-ation (GRADE) approach was used to evaluate the level of evidence available per statement. To determine the level of agreement, the working group voted on the 14 statements for strength of agreement, using a nine-point Likert scale in order to calculate Cronbach's alpha reliability coefficient.
Results: Strong consensus and agreement were obtained for the following statements: Alcohol, smoking, and certain genetic alterations are risk factors for CP. Past history, family history, onset of symptoms, and life-style factors including alcohol intake and smoking history should be determined. Alcohol con-sumption dose-dependently elevates the risk of CP up to 4-fold. Ever smokers, even smoking less than a pack of cigarettes per day, have an increased risk for CP, as compared to never smokers.
Conclusions: Both genetic and environmental factors can markedly elevate the risk for CP. Therefore, health-promoting lifestyle education and in certain cases genetic counselling should be employed to reduce the incidence of CP. (C) 2020 IAP and EPC. Published by Elsevier B.V.
Filiaciones:
Hegyi, P:
Univ Pecs, Inst Translat Med, Sch Med, 12 Szigeti St,2 Floor, H-7624 Pecs, Hungary
Univ Pecs, Dept Translat Med, Sch Med, Pecs, Hungary
Univ Pecs, Med Sch, Dept Med 1, Pecs, Hungary
Univ Szeged, Fac Med, MTA, SZTE Momentum Translat Gastroenterol Res Grp, Szeged, Hungary
Univ Szeged, Fac Med, Dept Med 1, Szeged, Hungary
Parniczky, A:
Univ Pecs, Inst Translat Med, Sch Med, 12 Szigeti St,2 Floor, H-7624 Pecs, Hungary
Univ Pecs, Dept Translat Med, Sch Med, Pecs, Hungary
Heim Natl Inst Pediat, Budapest, Hungary
Lerch, M:
Univ Med Greifswald, Dept Med, Greifswald, Germany
Sheel, A:
Univ Liverpool, Inst Translat Med, Dept Clin Canc Med, Liverpool, Merseyside, England
Rebours, V:
Univ Paris, Beaujon Hosp, APHP, Pancreatol Unit, Paris, France
Forsmark, C:
Univ Florida, Div Gastroenterol Hepatol & Nutr, Gainesville, FL 32611 USA
Del Chiaro, M:
Univ Colorado, Dept Surg, Div Surg Oncol, Anschutz Med Campus, Denver, CO 80045 USA
Rosendahl, J:
Martin Luther Univ Halle Wittenberg, Dept Internal Med 1, Halle, Germany
:
Alicante Univ Gen Hosp, Alicante Inst Hlth & Biomed Res ISABIAL, Gastroenterol Dept, Alicante, Spain
Szucs, A:
Semmelweis Univ, Fac Med, Dept Surg 1, Budapest, Hungary
Takaori, K:
Kyoto Univ, Dept Surg, Grad Sch Med, Kyoto, Japan
Yadav, D:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA 15260 USA
Gheorghe, C:
Carol Davila Univ Med & Pharm, Ctr Gastroenterol & Hepatol, Fundeni Clin Inst, Bucharest, Romania
Rakonczay, Z:
Univ Szeged, Fac Med, Dept Pathophysiol, Szeged, Hungary
Molero, X:
Autonomous Univ Barcelona, Hosp Univ Vall dHebron, Inst Recerca, Exocrine Pancreas Res Unit,CIBEREHD, Barcelona, Spain
Inui, K:
Fujita Hlth Univ, Teaching Hosp 2, Dept Gastroenterol, Nagoya, Aichi, Japan
Masamune, A:
Tohoku Univ, Div Gastroenterol, Grad Sch Med, Sendai, Miyagi, Japan
Fernandez-Del Castillo, C:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Surg, Boston, MA 02115 USA
Shimosegawa, T:
South Miyagi Med Ctr, Dept Gastroenterol, Ohgawara, Miyagi, Japan
Neoptolemos, J:
Heidelberg Univ, Dept Gen Surg, Heidelberg, Germany
Whitcomb, D:
Univ Pittsburgh, Dept Med, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA 15260 USA
Sahin-Toth, M:
Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90095 USA
Green Accepted, Hybrid Gold
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