Estimation of EUS findings of early chronic pancreatitis in comparison with clinical symptoms

Background: Recently, the concept of early chronic pancreatitis (ECP) were reported and EUS findings of ECP (EUS-ECP) were proposed. However, the details of ECP has not been yet discussed. In this study, we tried to reveal the clinical significance of EUS-ECP and the usefulness of early treatment intervention.Patients and Methods: Recorded movie images of the pancreatic parenchyma in the 5305 cases who underwent EUS from March 2009 to December 2013 were evaluated whether they had EUS-ECP. Causation of EUS-ECP and clinical features of CP; (1)repeated upper abdominal pain, (2)abnormality of pancreatic enzymes, (3)alcohol consumption 80g>/day, (4) smoking and (5) diabetes were examined.Furthermore, in 39 cases with early treatment after diagnosis of ECP, improvement rate of the clinical features and the change of the number of EUS-ECP were examined.Results: EUS-ECP were significantly positive in the cases with (1), (2), (3) and (5). (p<0.05)The cases with EUS-ECP such as lobularity with honeycombing and strands had the symptoms (1) and (3) significantly. (p<0.01)In 41%(16/39) cases, the symptoms (1) and (2) were improved by early treatment intervention. In 11 cases with EUS reexamination, the average number of EUS-ECP were decreased in 2.91±0.43 from 3.72±0.35.Conclusion: The validity of diagnostic EUS criteria of the ECP was confirmed. The early treatment intervention to ECP may improve the prognosis of CP.