Bagul Anil, Siriwardena Ajith K
Hepatobiliary Surgical Unit, Manchester Royal Infirmary. Manchester, United Kingdom.
JOP. 2006 Jul 10;7(4):390-6.
Classifications of chronic pancreatitis based on either histologic (Marseilles) or endoscopic (Cambridge) criteria are not widely used.
The present study describes the development and validation of a three-stage clinical categorical classification system for chronic pancreatitis.
Patients with a diagnosis of chronic pancreatitis (577.1: ICD-9) for 1993 were identified from records of the Hepatopancreaticobiliary service at a University hospital. Endoscopic or CT evidence of chronic pancreatitis were mandatory for inclusion.
Forty one patients met the criteria and were categorized according to a 3-stage system as mild, moderate or end-stage disease.
The clinical course over the subsequent decade was followed by chart review with re-categorization of stage at each review.
At the outset of the study, 18 (44%) patients were categorised as having mild disease, 19 (46%) as moderate and 4 (10%) as end-stage. The number of patients with mild disease fell over the subsequent 5 years and at the end of the 10-year chart study period, no patients were categorised as mild. The number of patients with diabetes at the outset of the study period was 2 (5%). At two years this was 3 (7%), five years 10 (24%) and 10 years was 25 (61%).
These results show that the Manchester classification of chronic pancreatitis is both practical and feasible and now requires prospective evaluation and independent appraisal by other centres.
基于组织学（马赛）或内镜（剑桥）标准的慢性胰腺炎分类未被广泛应用。
本研究描述了一种慢性胰腺炎三阶段临床分类系统的开发与验证。
从一家大学医院肝胰胆科的记录中识别出1993年诊断为慢性胰腺炎（国际疾病分类第九版代码：577.1）的患者。纳入患者必须有慢性胰腺炎的内镜或CT证据。
41名患者符合标准，并根据三阶段系统分为轻度、中度或终末期疾病。
通过查阅病历对随后十年的临床病程进行随访，并在每次复查时重新分类疾病阶段。
在研究开始时，18名（44%）患者被分类为轻度疾病，19名（46%）为中度，4名（10%）为终末期。轻度疾病患者数量在随后5年中减少，在10年病历研究期结束时，没有患者被分类为轻度。研究开始时患有糖尿病的患者有2名（5%）。两年时为3名（7%），五年时为10名（24%），十年时为25名（61%）。
这些结果表明，慢性胰腺炎的曼彻斯特分类既实用又可行，现在需要其他中心进行前瞻性评估和独立评价。
