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Idiopathic Chronic Pancreatitis in Bihar: A Perspective from Eastern India
 
Utpal Anand1, Ramesh Kumar2, Rajeev Nayan Priyadarshi3, Bindey Kumar4, Sanjay Kumar5, Kunal Parasar1
1Department of Surgical Gastroenterology, AIIMS, Patna, Bihar, India. 2Department of Gastroenterology, AIIMS, Patna, Bihar, India. 3Department of Radiodiagnosis, AIIMS, Patna, Bihar, India. 4Department of Paediatric Surgery, AIIMS, Patna, Bihar, India. 5Department of Surgical Gastroenterology, IGIMS, Patna, Bihar, India.


Corresponding Author
:
Dr Utpal Anand 
Email: utpalanand2@gmail.com,  drutpalanand@aiimspatna.org


Abstract

Background: There is a lack of data describing the clinical profile, complications, and treatment outcome of patients with idiopathic chronic pancreatitis (ICP) from Eastern India. The current study aimed to present data on these aspects from a tertiary care centre of Bihar - a part of Eastern India. 
Methods: Prospective data were collected with regard to clinic-epidemiological profile, complication, and treatment outcome from each patient of ICP (n=129). The median follow-up period was 3.8 (01 - 06) years. 
Results: ICP constituted the most common (64.1%, 129/201) cause of chronic pancreatitis. The mean age ± SD of ICP patients was 31.5 ± 11.2 years, and 71 (55%) were male. Diabetes and symptomatic steatorrhea were found in 25% (n=33) and 6.2% (n=08) patients. Pancreatic head mass was found in 43 (33%) patients, of which 17 (39.5%) was malignant. When patients were categorized into early-onset (= 30 years) and late-onset (>30 years) groups, no significant difference was found with regard to the proportion of patients with diabetes, head mass, and malignancy. The majority (69.7%) of patients required surgery (Frey’s procedure) due to failed medical therapy. Seventy-four (82%) patients had significant pain relief during a median follow-up of 3.8 years after surgery. 
Conclusions: ICP is the most common cause of chronic pancreatitis in Bihar. The majority of such patients are young, with slight male preponderance. They have a significant risk of developing diabetes and pancreatic malignancy. They are poorly responsive to medical therapy, and the outcome of surgical therapy is good.