Idiopathic Chronic Pancreatitis in Bihar: A Perspective from  Eastern India

Utpal Anand; Ramesh Kumar; Rajeev Nayan Priyadarshi; Bindey Kumar; Sanjay Kumar; Kunal Parasar

doi:10.7869/tg.580

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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.