title: Evaluation of the Manchester classification system for chronic pancreatitis.
abstract: BACKGROUND
  Classifications of chronic pancreatitis based on either histologic (Marseilles) or endoscopic (Cambridge) criteria are not widely used.
  
  
  OBJECTIVE
  The present study describes the development and validation of a three-stage clinical categorical classification system for chronic pancreatitis.
  
  
  METHODS
  Patients with a diagnosis of chronic pancreatitis (577.1: ICD-9) for 1993 were identified from records of the Hepatopancreaticobiliary service at a University hospital. Endoscopic or CT evidence of chronic pancreatitis were mandatory for inclusion.
  
  
  METHODS
  Forty one patients met the criteria and were categorized according to a 3-stage system as mild, moderate or end-stage disease.
  
  
  METHODS
  The clinical course over the subsequent decade was followed by chart review with re-categorization of stage at each review.
  
  
  RESULTS
  At the outset of the study, 18 (44%) patients were categorised as having mild disease, 19 (46%) as moderate and 4 (10%) as end-stage. The number of patients with mild disease fell over the subsequent 5 years and at the end of the 10-year chart study period, no patients were categorised as mild. The number of patients with diabetes at the outset of the study period was 2 (5%). At two years this was 3 (7%), five years 10 (24%) and 10 years was 25 (61%).
  
  
  CONCLUSIONS
  These results show that the Manchester classification of chronic pancreatitis is both practical and feasible and now requires prospective evaluation and independent appraisal by other centres.
authors.affiliation: Hepatobiliary Surgical Unit, Manchester Royal Infirmary. Manchester, United Kingdom. ajith.siriwardena@cmmc.nhs.uk
authors.forename: Anil
authors.initials: A
authors.lastname: Bagul
authors.forename: Ajith K
authors.initials: AK
authors.lastname: Siriwardena
mesh_terms: D000328:Adult; D000368:Aged; D002965:Classification / Q000379:methods; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000145:classification* / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed