Lankisch P G, Löhr-Happe A, Otto J, Creutzfeldt W
Medizinische Abteilung, Städtischen Krankenhauses Lüneburg.
Zentralbl Chir. 1995;120(4):278-86.
The natural course of the classical symptoms of chronic pancreatitis, i.e. pain, exocrine and endocrine pancreatic insufficiency, was followed up in 335 patients over a median of 9.8 years (mean 11.3 +/- 8.3 years). Pain relief was not obtained in the majority of patients, even after a longterm observation of > 10 years, and severe exocrine and/or endocrine insufficiency, severe duct abnormalities and pancreatic calcifications developed. Alcohol abstinence failed to have a significant beneficial effect on pain. Pancreatic surgery led to pain relief immediately after operation, but later on the pain course between operated and nonoperated patients was not significantly different. Repeated exocrine pancreatic function tests in 143 patients showed that functional exocrine impairment came to a standstill (46%), or improved (11%). At the end of the observation, 22% of 335 patients still had normal endocrine function and only 40% required insulin treatment. Alcohol abstinence had a significant beneficial effect on endocrine, but not on exocrine pancreatic insufficiency. Chronic pancreatitis led to a sharp increase in unemployment and retirement. Pancreatic carcinoma occurred in 3% and extrapancreatic carcinoma in 4%. The mortality rate within the observation period was 22%, pancreatitis-induced complications accounted for 13% of these deaths.
对335例慢性胰腺炎患者的典型症状（即疼痛、胰腺外分泌和内分泌功能不全）的自然病程进行了随访，中位随访时间为9.8年（平均11.3±8.3年）。即使经过超过10年的长期观察，大多数患者的疼痛仍未缓解，并且出现了严重的外分泌和/或内分泌功能不全、严重的导管异常和胰腺钙化。戒酒对疼痛没有显著的有益影响。胰腺手术后疼痛立即缓解，但术后一段时间后，手术患者和未手术患者的疼痛病程并无显著差异。对143例患者进行的多次胰腺外分泌功能测试表明，功能性外分泌损害停止（46%）或有所改善（11%）。在观察结束时，335例患者中有22%的内分泌功能仍正常，只有40%的患者需要胰岛素治疗。戒酒对内分泌功能不全有显著的有益影响，但对外分泌功能不全没有影响。慢性胰腺炎导致失业率和退休率急剧上升。胰腺癌的发生率为3%，胰腺外癌的发生率为4%。观察期内的死亡率为22%，胰腺炎引起的并发症占这些死亡人数的13%。
