Department of Population Health, QIMR Berghofer Medical Research Institute.
Gastroenterology Department, John Hunter Hospital, New Lambton Heights, NSW.
J Clin Gastroenterol. 2022 Jan 1;56(1):e1-e10. doi: 10.1097/MCG.0000000000001544.
We aimed to extract the percent of signs and symptoms at the time of diagnosis from published studies and to pool these using meta-analytic techniques.
Delayed or misdiagnosis of chronic pancreatitis may occur because the signs and symptoms are nonspecific and varied.
We performed a systematic review of studies reporting the signs and symptoms of chronic pancreatitis at diagnosis. The percentage of patients with each sign and symptom was extracted and random-effects meta-analyses used to calculate pooled percentages.
In total, 22 observational studies were included. Across 14 studies, 55% of chronic pancreatitis patients were classified as having alcoholic etiology. Abdominal pain was the most common symptom (76%), and weight loss was reported in 22% of patients. Jaundice occurred in 11% of patients and steatorrhoea in 3%. Half of the patients had a history of acute pancreatitis, and 28% had diabetes mellitus at diagnosis. Heterogeneity between the studies was high for all signs and symptoms.
This research has identified some common features of patients with chronic pancreatitis, but the high heterogeneity makes it difficult to draw solid conclusions. Carefully designed studies to examine the signs and symptoms leading up to a diagnosis of chronic pancreatitis, and common combinations, are required. These would enable the development of a tool to aid in the early identification of chronic pancreatitis in the primary care setting, with potential for improved short-term and long-term outcomes for patients.
我们旨在从已发表的研究中提取诊断时出现的症状和体征的百分比，并使用荟萃分析技术对这些数据进行汇总。
慢性胰腺炎的诊断可能会出现延迟或误诊，因为其症状并不特异且多种多样。
我们对报道慢性胰腺炎诊断时症状和体征的研究进行了系统回顾。提取了每位患者出现每种症状和体征的百分比，并使用随机效应荟萃分析计算汇总百分比。
共纳入 22 项观察性研究。在 14 项研究中，55%的慢性胰腺炎患者被归类为酒精性病因。腹痛是最常见的症状（76%），22%的患者报告体重减轻。11%的患者出现黄疸，3%的患者出现脂肪泻。一半的患者有急性胰腺炎病史，28%的患者在诊断时患有糖尿病。所有症状和体征的研究间异质性均较高。
本研究确定了慢性胰腺炎患者的一些常见特征，但高异质性使得难以得出确凿的结论。需要精心设计研究来检查导致慢性胰腺炎诊断的症状和体征，以及常见的组合。这将有助于开发一种工具，以帮助在初级保健环境中早期识别慢性胰腺炎，从而有可能改善患者的短期和长期预后。
