International Consensus Guidelines for Risk Factors in Chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club
International Consensus Guidelines for Risk Factors in Chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club
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DOI：
10.1016/j.pan.2020.03.014
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发表时间：
2020-06-01
期刊：
影响因子：
3.6
通讯作者：
Sahin-Toth, Miklos
中科院分区：
文献类型：
--
作者：
Hegyi, Peter;Parniczky, Andrea;Sahin-Toth, Miklos
背景：慢性胰腺炎（CP）是一种复杂的炎症性疾病，严重影响患者的生活质量和胰腺的永久性损伤。本文是CP的国际共识指南的一部分，并提出了CP的风险升高因素的共识。方法：一个国际工作组，20名专家CP从主要胰腺协会（IAP，阿帕，JPS，EPC）评估了14个声明，从证据中产生的四个问题被认为是最临床相关的CP。建议评估、开发和评价分级（GRADE）方法用于评价每个声明的可用证据水平。为了确定协议的水平，工作组投票的14个声明的协议强度，使用9点李克特量表，以计算Cronbach的α reliability coefficients.Results：强烈的共识和协议，获得了以下声明：酒精，吸烟，和某些遗传变异的风险因素CP。应确定既往史、家族史、症状发作以及生活方式因素，包括饮酒和吸烟史。酒精消耗量依赖性地增加CP的风险高达4倍。曾经吸烟者，即使每天吸烟少于一包香烟，有CP的风险增加，相比从不吸烟者。结论：遗传和环境因素可以显着增加CP的风险。因此，健康促进生活方式的教育和在某些情况下遗传咨询，应采用减少CP的发病率。(C)2020年IAP和EPC。由爱思唯尔公司出版
Background: Chronic pancreatitis (CP) is a complex inflammatory disease with remarkably impaired quality of life and permanent damage of the pancreas. This paper is part of the international consensus guidelines on CP and presents the consensus on factors elevating the risk for CP.Methods: An international working group with 20 experts on CP from the major pancreas societies (IAP, APA, JPS, and EPC) evaluated 14 statements generated from evidence on four questions deemed to be the most clinically relevant in CP. The Grading of Recommendations Assessment, Development, and Evalu-ation (GRADE) approach was used to evaluate the level of evidence available per statement. To determine the level of agreement, the working group voted on the 14 statements for strength of agreement, using a nine-point Likert scale in order to calculate Cronbach's alpha reliability coefficient.Results: Strong consensus and agreement were obtained for the following statements: Alcohol, smoking, and certain genetic alterations are risk factors for CP. Past history, family history, onset of symptoms, and life-style factors including alcohol intake and smoking history should be determined. Alcohol con-sumption dose-dependently elevates the risk of CP up to 4-fold. Ever smokers, even smoking less than a pack of cigarettes per day, have an increased risk for CP, as compared to never smokers.Conclusions: Both genetic and environmental factors can markedly elevate the risk for CP. Therefore, health-promoting lifestyle education and in certain cases genetic counselling should be employed to reduce the incidence of CP. (C) 2020 IAP and EPC. Published by Elsevier B.V.