Chronic pancreatitis

Braganza, Joan M; Lee, Stephen H; McCloy, Rory F; McMahon, Michael J

doi:10.1016/s0140-6736(10)61852-1

Cited by 469Pancreatitis Pathology and TreatmentIgG4-Related and Inflammatory DiseasesPancreatic and Hepatic Oncology Research

Chronic pancreatitis

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Braganza, Joan M, Lee, Stephen H, McCloy, Rory F, McMahon, Michael J·2011·The Lancet

DOI 10.1016/s0140-6736(10)61852-1PMC PMC1379062

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Abstract

Chronic pancreatitis is a progressive fibroinflammatory disease that exists in large-duct (often with intraductal calculi) or small-duct form. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals) and genetic factors (eg, mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator); a few patients have hereditary or autoimmune disease. Pain in the form of recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells) or constant and disabling pain is usually the main symptom. Management of the pain is mainly empirical, involving potent analgesics, duct drainage by endoscopic or surgical means, and partial or total pancreatectomy. However, steroids rapidly reduce symptoms in patients with autoimmune pancreatitis, and micronutrient therapy to correct electrophilic stress is emerging as a promising treatment in the other patients. Steatorrhoea, diabetes, local complications, and psychosocial issues associated with the disease are additional therapeutic challenges.

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The pathogenesis is different for acute and chronic pancreatitis, but alcohol use has a significant impact on the pathophysiology of both and in the transition from acute to chronic pancreatitis.
“The pathogenesis is different for acute and chronic pancreatitis, but alcohol use has a significant impact on the pathophysiology of both 298, 299, 300, 301, 302 and in the transition from acute to chronic pancreatitis (see 303 ).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [299]
This process is mediated by sustained elevation of the cytosolic Ca2+ levels and results ultimately in releasing pancreatic enzymes into the interstitium and in chronic inflammation.
“This process is mediated by sustained elevation of the cytosolic Ca2+ levels 307 and results ultimately in releasing pancreatic enzymes into the interstitium and in chronic inflammation 299.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [299]

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Authors: Braganza, J. M., Lee, S. H., McCloy, R. F., & McMahon, M. J.
Affiliations: Manchester Royal Infirmary (GB)
Lancashire Teaching Hospitals NHS Foundation Trust (GB)
University of Leeds (GB)
Corresponding author: Braganza, Joan M
ORCID: Lee, Stephen H
McMahon, Michael J
Venue: The Lancet
Publisher: Elsevier BV
Published: 2011-04
Volume: 377
Issue: 9772
Pages: 1184-1197
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(10)61852-1
PMC: PMC1379062
OpenAlex: W4211115676
Cited by: 469
References: 122
Citations by year: 2026: 12 · 2025: 13 · 2024: 14 · 2023: 19 · 2022: 27 · 2021: 29 · 2020: 24 · 2019: 32 · 2018: 27 · 2017: 49 · 2016: 50 · 2015: 41 · 2014: 41 · 2013: 45 · 2012: 36
FWCI: 7.50
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Health Sciences › Medicine › Rheumatology › IgG4-Related and Inflammatory Diseases
Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Keywords: chronic pancreatitis, fibroinflammatory disease, alcohol, smoking, occupational chemicals, cystic fibrosis transmembrane conductance regulator, hereditary pancreatitis, autoimmune pancreatitis, pancreatic pain, analgesia, endoscopic drainage, pancreatic resection, corticosteroids, micronutrient therapy, steatorrhea, diabetes mellitus, psychosocial problems
MeSH terms: Algorithms, Animals, Anti-Inflammatory Agents, Cholangiopancreatography, Endoscopic Retrograde, Diabetes Mellitus, Disease Models, Animal, Drainage, Fibrosis, Humans, Ischemia, Magnetic Resonance Imaging, Mutation, Pancreas, Pancreatectomy, Pancreaticojejunostomy, Prednisolone, Risk Factors, Smoking, Biomarkers, Autoimmunity, Abdominal Pain, Endoscopy, Digestive System, Disease Progression, Micronutrients, Pancreatitis, Acute Necrotizing, Pancreatitis, Alcoholic, Genetic Predisposition to Disease, Steatorrhea, Pancreatitis, Chronic

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