Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?
OBJECTIVE
To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes.


METHODS
One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed.


RESULTS
In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients.


CONCLUSIONS
There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.
Aparisi
Luis
L
Liver Unit, Hospital Clinico Universitario, Avda. Blasco Ibanez 17, Valencia 46010, Spain. aparisi_lui@gva.es
Sabater
Luis
L
Del-Olmo
Juan
J
Sastre
Juan
J
Serra
Miguel-Angel
MA
Campello
Ricardo
R
Bautista
Daniel
D
Wassel
Abdalla
A
Rodrigo
Jose-Manuel
JM
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D015992:Body Mass Index; D002352:Carrier Proteins / Q000032:analysis; D016022:Case-Control Studies; D004396:Coloring Agents; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010196:Pancreatic Elastase; D010186:Pancreatic Function Tests; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013030:Spain / Q000453:epidemiology
D002352:Carrier Proteins; D004396:Coloring Agents; D010196:Pancreatic Elastase; C017130:cholesterol-binding protein; D007208:Indocyanine Green