J Gastroenterol 2000; 35:136-41.
Nationwide
epidemiological survey of chronic pancreatitis in Japan
Lin Y, Tamakoshi A, Matsuno
S, Takeda K, Hayakawa T, Kitagawa M, Naruse S,
Kawamura T, Wakai K, Aoki R, Kojima M, Ohno Y
Department of Preventive Medicine, Nagoya University School of Medicine.
Nagoya, Japan
JOP expert comment (R Pezzilli: pezzilli@orsola-malpighi.med.unibo.it)
The authors have estimated the number of patients treated
for chronic pancreatitis in 1994 in Japan and have explored the clinical and
epidemiological features of the disease.
The number of patients with chronic pancreatitis
treated in 1994 in Japan was estimated as 32,000, with an overall prevalence
rate of 45.4 per 100,000 population in males and 12.4 in females. Alcoholic
pancreatitis was the most common type in males (68.5%), and idiopathic
pancreatitis in females (69.6%). Compared to the findings in a previous
Japanese survey carried-out in 1985, the proportion of idiopathic chronic
pancreatitis increased in both males and females. Patients diagnosed using
advanced techniques such as computed tomography and endoscopic retrograde cholangiopancreatography accounted for 68.1% of the total.
This is one of the few studies on the prevalence of
chronic pancreatitis. It is of great importance that other similar studies be
carried out in Western countries in order to better understand the real
prevalence and incidence of the disease and the exact role of new genetic and
radiological techniques in defining the etiology and in assessing the diagnosis
of the disease especially in those patients defined as having an idiopathic
pancreatitis.
Am J Gastroenterol 2000; 95:441-5
Outcome
after surgical resection of intraductal papillary and
mucinous tumors of the pancreas
Cuillerier E, Cellier C, Palazzo L, Deviere J, Wind P, Rickaert F, Cugnenc PH, Cremer M, Barbier JP
Department of Gastroenterology, Laennec Hospital. Paris, France
JOP expert comment (G Uomo: uomogir@libero.it)
In this study, the authors report the data of a study
carried out to evaluate the risk of recurrence in 45 patients with intraductal papillary and mucinous tumors of the pancreas
(IPMT) after surgery according to the histological nature of the neoplasm and
the type of surgery.
The overall 3-yr actuarial survival rate was 83%.
Death occurred in 35% of patients with invasive carcinoma and in 4% of patients
with noninvasive tumors (p<0.05). In patients with invasive carcinoma, total
pancreatectomy and the absence of lymph node involvement were independently
associated with a low risk of recurrence. On the basis of these results the
authors concluded that in patients with noninvasive neoplasms, partial
pancreatic resection should be guided by frozen section examination until
disease-free margins are obtained; and in patients with invasive carcinoma,
total pancreatectomy seems the most likely means of curing the patient.
Even if the number of patients studied for the purpose
of obtaining definitive results on this topic is not numerous, a multicenter
study on a larger number of patients with IPMT in order to confirm these
results would be welcome. Furthermore more attention should be paid to the
quality of the life of patients operated on. In fact, the social costs are at
present an important variable of these types of study.