Painless chronic pancreatitis: experiences from a high-volume center

Abstract

Introduction

Although abdominal pain is the most prevalent and disabling symptom in patients with chronic pancreatitis (CP), there are also patients who have painless CP.

Patients and methods

We performed a retrospective analysis of patients with a diagnosis of CP. A total of 279 patients with definite CP with completed demographic and clinical data were included in the final analysis.

Results

There were 75 (26.9%) patients with painless CP. These patients had a significantly higher mean age at diagnosis, 61.7 years, than the 52.5 years of patients with pain (p < 0.001). Painless and painful CP had similar rates of diabetes mellitus (DM) (28.4% vs. 31.6%) and pancreatic exocrine insufficiency (PEI) (50.0% vs. 52.3%). Painless CP had lower rates of alcoholic etiology, 36.0%, than the 52.5% in painful CP (p < 0.05). Patients older than 55 at the time of CP diagnosis were associated with painless CP with an adjusted odds ratio (aOR) of 3.27 [95% confidence interval (CI): 1.62–6.60]. Alcoholic etiologies were not associated with painless CP, aOR of 0.51 (95% CI: 0.25–0.91).

Conclusion

Patients with painless CP had a significantly higher mean age than patients with painful CP and increased aOR for those older than 55 at CP diagnosis. Painless and painful CP patients had similar rates of DM and PEI, confirming the necessity of routine follow up in all patients with CP.

Keywords:

• Chronic pancreatitis
• pain
• endoscopy
• surgery
• painless

Acknowledgment

The authors thank the Swedish Society for Development of Pancreatology (SveSuP) for continuing support, promotion and creating awareness of pancreatic diseases in Swedish society.

Author contributions

MV, J-ML and PG contributed to study conception and design. MK, MG, AD and MV contributed to acquisition of data. EA contributed to statistical analysis. All authors contributed to writing of the manuscript and approved the final version of the article, including the authorship list.

Disclosure statement

MV and J-ML: Abbott (lecture fee) and Mylan (lecture fee).

Additional information

Funding

MV was funded by Swedish Magtarmfondens stipendium for research; Ruth and Richard Julin Foundation for research (not related to the present study).