Early diagnosis of chronic pancreatitis

I. E. Khatkov, Elena Y. Tyulyaeva, K. Lesko, E. Dubtsova, D. S. Bordin, Mariia A. Kiriukova, M. Malykh, Ludmila V. Vinokurova
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引用次数: 23

Abstract

Chronic pancreatitis is one of the most challenging disorders from the perspective of its early diagnosis and effective treatment. Within the last decade, the diagnosis of early chronic pancreatitis has been firmly introduced into the practice of gastroenterology. The delineation of this form as an initial stage of chronic pancreatitis is based on the need in early and effective treatment that could cease the progression of the disease and reduce the possibility of its complications. The diagnostic criteria of chronic pancreatitis have been described in details in the literature; however, specifics of the diagnosis in its early stage have been scarcely highlighted. Chronic pancreatitis is commonly diagnosed with a number of imaging techniques (they can show abnormalities in morphology of the pancreas), as well as laboratory tests (showing functional organ deficit). However, morphological and imaging techniques are insufficient for the diagnosis of the early chronic pancreatitis. A new integral strategy towards early diagnosis seems necessary, that would consider not only the morphology, but also potential etiology, risk factors of the disease and its complications in patients with suspected chronic pancreatitis. The review of the literature presents the definition of the early pancreatitis and discusses the potential of imaging techniques and functional tests in its diagnosis. An adequate strategy for the diagnosis of the early pancreatitis is formulated, based on an individual patient characteristic with suspected early chronic pancreatitis, namely, risk factors, clinical manifestations, imaging results and serological biomarkers.
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慢性胰腺炎的早期诊断
从早期诊断和有效治疗的角度来看,慢性胰腺炎是最具挑战性的疾病之一。在过去的十年中,早期慢性胰腺炎的诊断已经被引入到胃肠病学的实践中。将这种形式描述为慢性胰腺炎的初始阶段是基于早期有效治疗的需要,以阻止疾病的进展并减少其并发症的可能性。慢性胰腺炎的诊断标准已在文献中详细描述;然而,早期诊断的细节几乎没有得到强调。慢性胰腺炎通常通过多种成像技术(可以显示胰腺形态异常)和实验室检查(显示功能器官缺陷)进行诊断。然而,形态学和影像学技术对早期慢性胰腺炎的诊断是不够的。一种新的综合早期诊断策略似乎是必要的,这将不仅考虑形态学,而且考虑潜在的病因学,疾病的危险因素及其并发症的疑似慢性胰腺炎患者。本文回顾了早期胰腺炎的定义,并讨论了成像技术和功能测试在其诊断中的潜力。根据疑似早期慢性胰腺炎患者的个体特征,即危险因素、临床表现、影像学结果和血清学生物标志物,制定适当的早期胰腺炎诊断策略。
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