Evidence-based clinical practice guidelines for chronic pancreatitis 2021
Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal i...
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| Published in: | Journal of gastroenterology Vol. 57; no. 10; pp. 709 - 724 |
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| Main Authors: | , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Singapore
Springer Nature Singapore
01.10.2022
Springer Springer Nature B.V |
| Subjects: | |
| ISSN: | 0944-1174, 1435-5922, 1435-5922 |
| Online Access: | Get full text |
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| Abstract | Background
Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress.
Methods
The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions.
Results
Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition.
Conclusions
These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. |
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| AbstractList | Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress.BACKGROUNDChronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress.The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions.METHODSThe clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions.Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition.RESULTSBased on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition.These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP.CONCLUSIONSThese updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Methods The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. Results Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. Conclusions These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. BackgroundChronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress.MethodsThe clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions.ResultsBased on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition.ConclusionsThese updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Methods The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. Results Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. Conclusions These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental, and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. The clinical practice guidelines for CP in Japan were revised in 2021 based on the 2019 Japanese clinical diagnostic criteria for CP, which incorporate the concept of a pathogenic fibro-inflammatory syndrome in the pancreas. In this third edition, clinical questions are reclassified into clinical questions, background questions, and future research questions. Based on analysis of newly accumulated evidence, the strength of evidence and recommendations for each clinical question is described in terms of treatment selection, lifestyle guidance, pain control, treatment of exocrine and endocrine insufficiency, and treatment of complications. A flowchart outlining indications, treatment selection, and policies for cases in which treatment is ineffective is provided. For pain control, pharmacological treatment and the indications and timing for endoscopic and surgical treatment have been updated in the revised edition. These updated guidelines provide clinicians with useful information to assist in the diagnosis and treatment of CP. |
| Audience | Academic |
| Author | Masamune, Atsushi Enomoto, Nobuyuki Sakagami, Junichi Shimizu, Kyoko Sata, Naohiro Takeyama, Yoshifumi Fujimori, Nao Mochida, Satoshi Ohara, Hirotaka Ito, Tetsuhide Tahara, Junko Shimosegawa, Tooru Kida, Mitsuhiro Koike, Kazuhiko Ohtsuka, Takao Irisawa, Atsushi Hirota, Morihisa Kanno, Atsushi |
| Author_xml | – sequence: 1 givenname: Kyoko orcidid: 0000-0003-1221-0315 surname: Shimizu fullname: Shimizu, Kyoko email: shimizu.kyoko@twmu.ac.jp organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology, Department of Gastroenterology, Tokyo Women’s Medical University – sequence: 2 givenname: Tetsuhide surname: Ito fullname: Ito, Tetsuhide organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 3 givenname: Atsushi surname: Irisawa fullname: Irisawa, Atsushi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 4 givenname: Takao surname: Ohtsuka fullname: Ohtsuka, Takao organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 5 givenname: Hirotaka surname: Ohara fullname: Ohara, Hirotaka organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 6 givenname: Atsushi surname: Kanno fullname: Kanno, Atsushi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 7 givenname: Mitsuhiro surname: Kida fullname: Kida, Mitsuhiro organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 8 givenname: Junichi surname: Sakagami fullname: Sakagami, Junichi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 9 givenname: Naohiro surname: Sata fullname: Sata, Naohiro organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 10 givenname: Yoshifumi surname: Takeyama fullname: Takeyama, Yoshifumi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 11 givenname: Junko surname: Tahara fullname: Tahara, Junko organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 12 givenname: Morihisa surname: Hirota fullname: Hirota, Morihisa organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 13 givenname: Nao surname: Fujimori fullname: Fujimori, Nao organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 14 givenname: Atsushi surname: Masamune fullname: Masamune, Atsushi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 15 givenname: Satoshi surname: Mochida fullname: Mochida, Satoshi organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 16 givenname: Nobuyuki surname: Enomoto fullname: Enomoto, Nobuyuki organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 17 givenname: Tooru surname: Shimosegawa fullname: Shimosegawa, Tooru organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology – sequence: 18 givenname: Kazuhiko surname: Koike fullname: Koike, Kazuhiko organization: Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Practice Guidelines for Chronic Pancreatitis’’, The Japanese Society of Gastroenterology |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35994093$$D View this record in MEDLINE/PubMed |
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| ISSN | 0944-1174 1435-5922 |
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| Issue | 10 |
| Keywords | Pathogenic fibro-inflammatory syndrome Early chronic pancreatitis Prognosis Staging Surgical treatment Pancreatic enzyme replacement therapy Pancreatogenic diabetes Diagnosis 2019 CP clinical diagnostic criteria Endoscopic treatment Mechanistic definition Pancreatic exocrine insufficiency |
| Language | English |
| License | 2022. The Author(s). Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
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| PublicationTitle | Journal of gastroenterology |
| PublicationTitleAbbrev | J Gastroenterol |
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Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the... Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the pancreas in... Background Chronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the... BackgroundChronic pancreatitis (CP) is defined according to the recently proposed mechanistic definition as a pathological fibro-inflammatory syndrome of the... |
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| SubjectTerms | Abdominal Surgery Clinical medicine Clinical practice guidelines Colorectal Surgery Diagnostic equipment (Medical) Drug therapy Endoscopy - adverse effects Evidence-based medicine Gastroenterology Hepatology Humans Inflammation Medicine Medicine & Public Health Pain Pancreas Pancreas - pathology Pancreatitis Pancreatitis, Chronic - diagnosis Pancreatitis, Chronic - etiology Pancreatitis, Chronic - therapy Practice guidelines (Medicine) Review Risk Factors Surgical Oncology |
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| Title | Evidence-based clinical practice guidelines for chronic pancreatitis 2021 |
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