20 Feb 2024Article
Comparison of the Profile and Management of Chronic Pancreatitis between China and Western Countries: A Single-Center Experience and Literature Review
Yu-Yan Zhu 1Hong-Ying Li 2Ji-Long Fan 2Ling-Ling Zhang 2De-Qing Jiang 2Ji-Chao Huang 2Zai-Jun Yu 2Qun-Gang Ke 2Ye-Ming Wang 2Fu-Meng Yang 3
Affiliations
Article Info
1 Department of Oncology, Lianyungang Second People’s Hospital, 222000 Lianyungang, Jiangsu, China
2 Department of Hepatobiliary Surgery, Lianyungang Second People’s Hospital, 222000 Lianyungang, Jiangsu, China
3 Department of Clinical Lab, Lianyungang Second People’s Hospital, 222000 Lianyungang, Jiangsu, China
Ann. Ital. Chir., 2024, 95(1), 17-21;
Published: 20 Feb 2024
Copyright © 2024 The Author(s).
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Objective: The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology and surgical approaches to treating CP differ between China and Western countries. Therefore, this study aims to compare the disparities in CP profiles and management based on our single-center experience and recent data from the West. Methods: From January 2007 to December 2017, a total of 130 consecutive patients with histologically confirmed chronic pancreatitis (CP) underwent surgical treatment at the First Affiliated Hospital of Nanjing Medical University. The clinical features, etiology, risk factors, and operative procedures of these CP patients were analyzed and compared with recent data from Western countries. Results: Our patient cohort was predominantly male (3.19:1), with a median age of 50.2 ± 9.8 years. Upper abdominal pain was the most common symptom, present in 102 patients (78.5%). The most common etiology was obstructive factors (47.7%), followed by alcohol (34.6%). The incidence of genic mutation was 2%, significantly lower than rates reported in Western research. Steatorrhea, weight loss, and jaundice were present in 6.9%, 18.5%, and 17.7% of patients, respectively. Pancreatic cysts or pseudocysts were diagnosed in 7 patients (5.4%). The following procedures were performed: Partington procedure in 33 patients (25.4%), Frey procedure in 17 patients (13.2%), Berne procedure in 5 patients (3.9%), Beger procedure in 1 patient (0.8%), pancreaticoduodenectomy in 17 patients (13.1%), pylorus-preserving pancreaticoduodenectomy in 18 patients (13.9%), middle pancreatectomy in 1 patient (0.8%), and distal pancreatectomy in 9 patients (6.9%). Choledochojejunostomy was performed in 14 patients (10.8%), gastroenterostomy in 2 (1.5%), and 15 patients (11.5%) underwent aspiration biopsy. Conclusion: Our study confirms that, etiologically, obstructive chronic pancreatitis (CP) is more frequent in the Chinese population than in Western populations. Although diagnostic instruments and operative procedures in China and Western countries are roughly comparable, slight differences exist in relation to diagnostic flowcharts/criteria and the indications and optimal timing of surgery.
Keywords
- chronic pancreatitis
- risk factors
- treatment
- surgery