Aim: This study is about a questionnaire survey of delegates attending the chronic pancreatitis symposium at the 2016 meeting of the Pancreatic Society of Great Britain and Ireland and seeks a multidisciplinary “snapshot” overview of practice. Methods: A questionnaire was developed with multidisciplinary input. Questions on access to specialist care, methods of diagnosis and treatment including specific scenarios were incorporated. Eighty-three (66%) of 125 delegates effectively participated in this survey. Results: Twenty-four (29%) had neither a chronic pancreatitis MDT in their hospital nor a chronic pancreatitis referral MDT. Most frequently utilised diagnostic modalities were CT, MR and EUS with no respondents utilising duodenal intubation tests. Initial treatment was provided through non-opiate analgesia by 69 (93%), through the use of opiates by 56 (76%) and through the use of co-analgesics by 49 (66%). Fifty two (68%) routinely referred patients with alcohol-related disease for counselling. Preferred treatment for large duct disease without mass was endoscopic therapy. In older patients with a mass, pancreaticoduodenectomy was preferred. Conclusion: This is a small study likely to be skewed by sampling bias but is thought to be the first multidisciplinary survey of the management of chronic pancreatitis in the United Kingdom and Ireland. The results show a need for comprehensive access to specialist pancreatitis MDT care and there remains substantial variation in management.

Keywords:
Chronic pancreatitis, Clinical management
1.
Löhr JM, Dominguez-Munoz E, Rosendahl J, et al: United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterol J 2017; 5: 153–199.
2.
Nordback I, Pelli H, Lappalainen-Lehto R, et al: The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology 2009; 136: 848–855.
3.
Gachago C, Draganov PV: Pain management in chronic pancreatitis. World J Gastroenterol 2008; 14: 3137–3148.
4.
Siriwardena AK, Mason JM, Sheen AJ, et al: Antioxidant therapy does not reduce pain in patients with chronic pancreatitis: the ANTICIPATE study. Gastroenterology 2012; 143: 655–663.e1.
5.
Díte P, Ruzicka M, Zboril V, Novotný I: A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy 2003; 35: 553–558.
6.
Cahen DL, Gouma DJ, Nio Y, et al: Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med 2007; 356: 676–684.
7.
Suchsland T, Aghdassi A, Kühn K, et al: Predictive factors for and incidence of hospital readmissions of patients with acute and chronic pancreatitis. Pancreatology 2015; 3: 265–270.
8.
Cahen DL, Gouma DJ, Laramée P, et al: Long term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology 2011; 75: 98–106.
9.
Diener MK, Hüttner FJ, Kieser M, et al: Partial pancreaticoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multi-centre, randomised, controlled, double-blind ChroPac trial. Lancet 2017; 390: 1027–1037.
10.
Chonchubhair Ni HM, O’Shea B, O Kavanagh D et al: Chronic pancreatitis in primary and hospital based care in Ireland: the management of an orphan disease. JOP 2016; 17: 385–393.
11.
van Esch AA, Ahmed Ali UA, van Goor H, et al: A wide variation in diagnostic and therapeutic strategies in chronic pancreatitis: a Dutch national survey. JOP 2012; 13: 394–401.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.