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Is increased pancreatic pressure related to pain in chronic pancreatitis?

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Summary

In this study, we investigated the relationship between pain and pancreatic pressure in patients with chronic pancreatitis (CP). We studied 12 patients with CP undergoing surgery and five controls with cancer of the pancreatic tail. CP was staged on the basis of morphological (ERP) and functional (serum-pancreolauryl test) criteria. Patients kept daily records of the intensity of pain on a linear analog scale. Intraoperatively, pressure within the pancreas was assessed by the introduction of a fine needle into the pancreatic parenchyma connected to a pressure transducer. In controls, pressure was determined in macroscopically normal tissue in the head of the pancreas. Pancreatic pressure was significantly higher in CP than in controls (29.9 ± 3.1 vs 7.2 ± 1.1 mmHg, p < 0.001). No relationship was found between the pain score and the pancreatic pressure. Pressure was positively correlated with ductal changes (r = 0.831;p<0.001), but not with exocrine function of the pancreas. Postoperatively, pancreatic pressure fell by 15.3% in four patients with CP in whom pressure assessment was repeated after surgical decompression. We conclude that pancreatic parenchy pressure is not closely related to pain in CP.

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Authors and Affiliations

  1. Department of Internal Medicine-Gastroenterology, University of Ulm, Germany

    Gianpiero Manes & Oreste Piemmico

  2. General Surgery, University of Ulm, Germany

    Markus Büchler & Pierluigi Di Sebastiano

  3. Department of Internal Medicine, University of Bonn, S. Freud Str. 25, D-5300, Bonn, Germany

    Peter Malfertheiner

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  1. Gianpiero Manes
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  2. Markus Büchler
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  3. Oreste Piemmico
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  4. Pierluigi Di Sebastiano
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  5. Peter Malfertheiner
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Manes, G., Büchler, M., Piemmico, O. et al. Is increased pancreatic pressure related to pain in chronic pancreatitis?. Int J Pancreatol 15, 113–117 (1994). https://doi.org/10.1007/BF02924661

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  • DOI: https://doi.org/10.1007/BF02924661

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