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.

Humans International Cooperation Pancreatitis, Chronic / etiology Risk Factors
Classification Definition Genetics Risk factors Treatment

Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 20 12 2019
revised: 10 03 2020
accepted: 22 03 2020
pubmed: 8 5 2020
medline: 10 4 2021
entrez: 8 5 2020
Statut: ppublish

Résumé

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. 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 Evaluation (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. 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 consumption 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. 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.

Sections du résumé

BACKGROUND 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 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 Evaluation (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 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 consumption 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 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.

Identifiants

DOI: 10.1016/j.pan.2020.03.014 PMID: 32376198
pubmed: 32376198
pii: S1424-3903(20)30105-8
doi: 10.1016/j.pan.2020.03.014
pii:
doi:

Types de publication

Consensus Development Conference Journal Article Practice Guideline

Langues

eng

Sous-ensembles de citation

IM

Pagination

579-585

Informations de copyright

Copyright © 2020 IAP and EPC. All rights reserved.

Auteurs

Péter Hegyi (P)

Institute for Translational Medicine & Department of Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary; MTA-SZTE Momentum Translational Gastroenterology Research Group, Faculty of Medicine, University of Szeged, Szeged, Hungary; First Department of Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary. Electronic address: p.hegyi@tm-centre.org.

Andrea Párniczky (A)

Institute for Translational Medicine & Department of Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Heim Pál National Institute of Pediatrics, Budapest, Hungary.

Markus M Lerch (MM)

Department of Medicine, University Medicine Greifswald, Greifswald, Germany.

Andrea R G Sheel (ARG)

Department of Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, United Kingdom.

Vinciane Rebours (V)

Pancreatology Unit, Beaujon Hospital, APHP, Paris, Université de Paris, Paris-Diderot, France.

Chris E Forsmark (CE)

Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA.

Marco Del Chiaro (M)

Division of Surgical Oncology, Department of Surgery - University of Colorado Anschutz Medical Campus, Denver, USA.

Jonas Rosendahl (J)

Department of Internal Medicine I, Martin Luther University, Halle, Germany.

Enrique de-Madaria (E)

Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.

Ákos Szücs (Á)

First Department of Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary.

Kyoichi Takaori (K)

Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Dhiraj Yadav (D)

Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Cristian Gheorghe (C)

Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Zoltán Rakonczay (Z)

Department of Pathophysiology, Faculty of Medicine, University of Szeged, Szeged, Hungary.

Xavier Molero (X)

Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron - Institut de Recerca, Autonomous University of Barcelona, CIBEREHD, Barcelona, Spain.

Kazuo Inui (K)

Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Nagoya, Japan.

Atsushi Masamune (A)

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Carlos Fernandez-Del Castillo (C)

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Tooru Shimosegawa (T)

Department of Gastroenterology, South Miyagi Medical Center, Ohgawara, Miyagi, Japan.

John P Neoptolemos (JP)

Department of General Surgery, University of Heidelberg, Heidelberg, Germany.

David C Whitcomb (DC)

Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Miklós Sahin-Tóth (M)

Department of Surgery, University of California Los Angeles, Los Angeles, CA, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › International Consensus Guidelines for Risk...
questionsmedicales.fr › Sciences sociales › Internationalité › Coopération internationale › International Consensus Guidelines for Risk...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Pancréatite chronique › International Consensus Guidelines for Risk...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › International Consensus Guidelines for Risk...