Survey on chronic pancreatitis in the Asia-Pacific region.
OBJECTIVE
A survey was conducted of chronic pancreatitis (CP) in different countries in the Asia-Pacific region. The main objective of the survey was to generate a database containing information regarding the prevalence, etiology, clinical presentation, diagnostic work-up, and management of CP in the Asia-Pacific region.


METHODS
Data were collected from seven countries using a structured questionnaire. Expert participants were asked to respond to the questionnaire based on the data of patients with CP studied in their centers.


RESULTS
The prevalence of CP was found to be very high in southern India (114-200/100 000 population), in contrast to the low reported rate of 4.2/100 000 population in Japan. Alcohol was the most common etiological factor in Australia (95%) and Japan (54%) while idiopathic pancreatitis was the most common type in India (tropical pancreatitis) and China, accounting for approximately 70% of all cases of CP. Pain was the most common clinical feature. Diabetes and steatorrhea were uncommon. With regard to the diagnosis of CP, all the experts believed that a patient could be diagnosed as having CP in the presence of any one or more of the following: ductal changes on endoscopic retrograde cholangiopancreatography, a positive secretin test, pancreatic calcification, and endosonographic abnormalities suggestive of CP. Most experts suggested pancreatic enzymes and analgesics as initial medical therapy for pain relief in CP. Endotherapy was suggested as the therapy of choice if medical therapy failed. Surgery was offered only after the failure of endotherapy. Most experts agreed that research should focus on genetic abnormalities in CP and the role of endotherapy for pain relief.


CONCLUSIONS
The survey brought out the prevalent types and presentation of CP, common management practices, and also the shortcomings in the existing knowledge of CP in the Asia-Pacific region. These findings might help focus attention on the research priorities for CP in this region.
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Pramod Kumar
PK
Garg
Rakesh Kumar
RK
Tandon
D001208:Asia / Q000453:epidemiology; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D010139:Pacific Islands / Q000453:epidemiology; D010195:Pancreatitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires