title: Chronic pancreatitis: Multicentre prospective data collection and analysis by the Hungarian Pancreatic Study Group.
abstract: BACKGROUND
  Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life.
  
  
  OBJECTIVE
  Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic pancreatitis. Statistical analysis was performed on different questions.
  
  
  RESULTS
  Data on 229 patients (74% male and 26% female) were uploaded from 14 centres. Daily alcohol consumption was present in the aetiology of 56% of the patients. 66% of the patients were previously treated for acute exacerbation. One third of the patients had had previous endoscopic or surgical interventions. Pain was present in 69% of the cases, endocrine insufficiency in 33%, diarrhoea in 13% and weight loss in 39%. Diagnosis was confirmed with US (80%), CT scan (52%), MRI-MRCP (6%), ERCP (39%), and EUS (7,4%). A functional test was carried out in 5% of the patients. In 31% of the cases, an endoscopic intervention was performed with the need for re-intervention in 5%. Further elective surgical intervention was necessitated in 44% of endoscopies. 20% of the registered patients were primarily treated with surgery. The biliary complication rate for surgery was significantly smaller (2%) than endoscopy (27%); however, pancreatic complications were higher in the patients treated with surgery. Patients who smoked regularly needed significantly more surgical intervention following endoscopy (66.7% vs. 26.9%, p = 0.002) than non-smokers, and the ratio of surgical intervention alone was also significantly higher (27.3% vs. 10.8%, p = 0.004). The ratio of surgery in patients who smoked and drank was significantly higher (30.09% vs. 12.5%, p = 0.012) than in abstinent and non-smoking patients, similarly to the need for further surgical intervention after endoscopic treatment (71.43% vs. 27.78%, p = 0.004).
  
  
  CONCLUSIONS
  According to the data analysed, the epidemiological data and the aetiological factors in our cohort differ little from European trends. The study highlighted the overuse of ERCP as a diagnostic modality and the low ratio of use of endoscopic ultrasonography. The results proved that alcohol consumption and smoking represent risk factors for the increased need for surgical intervention. Chronic pancreatitis should be treated by multidisciplinary consensus grounded in evidence-based medicine.
authors.affiliation: First Department of Surgery, Semmelweis University, Budapest, Hungary.
authors.forename: Ákos
authors.initials: Á
authors.lastname: Szücs
authors.affiliation: First Department of Surgery, Semmelweis University, Budapest, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Marjai
authors.affiliation: Institute for Translational Medicine, University of Pécs, Pécs, Hungary.|First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Szentesi
authors.affiliation: Institute of Bioanalysis, University of Pécs, Pécs, Hungary.
authors.forename: Nelli
authors.initials: N
authors.lastname: Farkas
authors.affiliation: Heim Pál Children's Hospital, Budapest, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Párniczky
authors.affiliation: Second Department of Internal Medicine, University of Debrecen, Debrecen, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Nagy
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Kui
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Takács
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Czakó
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Balázs Csaba
authors.initials: BC
authors.lastname: Németh
authors.affiliation: Division of Gastroenterology, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Áron
authors.initials: Á
authors.lastname: Vincze
authors.affiliation: Division of Gastroenterology, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pár
authors.affiliation: Division of Gastroenterology, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Imre
authors.initials: I
authors.lastname: Szabó
authors.affiliation: Division of Gastroenterology, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Sarlós
authors.affiliation: Division of Gastroenterology, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Illés
authors.affiliation: Division of Translational Medicine, First Department of Medicine, University of Pécs, Pécs, Hungary.
authors.forename: Szilárd
authors.initials: S
authors.lastname: Gódi
authors.affiliation: Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Izbéki
authors.affiliation: Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Gervain
authors.affiliation: Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary.
authors.forename: Adrienn
authors.initials: A
authors.lastname: Halász
authors.affiliation: Department of Surgery, University of Szeged, Szeged, Hungary.
authors.forename: Gyula
authors.initials: G
authors.lastname: Farkas
authors.affiliation: Department of Surgery, University of Szeged, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Leindler
authors.affiliation: Department of Surgery, University of Pécs, Pécs, Hungary.
authors.forename: Dezső
authors.initials: D
authors.lastname: Kelemen
authors.affiliation: Department of Surgery, University of Pécs, Pécs, Hungary.
authors.forename: Róbert
authors.initials: R
authors.lastname: Papp
authors.affiliation: Department of Interventional Gastroenterology, National Institute of Oncology, Budapest, Hungary.
authors.forename: Richárd
authors.initials: R
authors.lastname: Szmola
authors.affiliation: Dr. Réthy Pál Hospital, Békéscsaba, Hungary.
authors.forename: Márta
authors.initials: M
authors.lastname: Varga
authors.affiliation: Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Hamvas
authors.affiliation: Pándy Kálmán Hospital of Békés County, Gyula, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Novák
authors.affiliation: Dr. Bugyi István Hospital, Szentes, Hungary.
authors.forename: Barnabás
authors.initials: B
authors.lastname: Bod
authors.affiliation: Center for Exocrine Disorders, Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, United States of America.
authors.forename: Miklós
authors.initials: M
authors.lastname: Sahin-Tóth
authors.affiliation: Institute for Translational Medicine, University of Pécs, Pécs, Hungary.|First Department of Medicine, University of Szeged, Szeged, Hungary.|Division of Translational Medicine, First Department of Medicine, University of Pécs, Pécs, Hungary.|Hungarian Academy of Sciences-University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Hegyi
mesh_terms: D016208:Databases, Factual; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life