Context The outcome of treatment for patients with chronic pancreatitis may be improved by multidisciplinary management.Objective To study patients with chronic pancreatitis, especially regarding alcohol use, within a multi disciplinary program. Main outcome measures Prospective assessment at baseline and follow-up of alcohol use disorders using DSM-IV criteria, AUDIT score, interview-based quantification of alcohol intake and the biomarker for alcohol use s-CDT in patients referred because of chronic pancreatitis together with retrospective classification with the M-ANNHEIM risk factor analysis and severity scoring for chronic pancreatitis. Results Sixty patients (95%) of 63 consecutively included patients were classified as having chronic pancreatitis. Forty four of these (73%) were available for follow-up evaluation, which took place after a minimum of 1 year (median 3 years). Alcohol consumption decreased at follow-up and no patients had ongoing alcohol dependence (P<0.001) as compared to 10 (23%) at initial evaluation. Patients with harmful alcohol use (AUDIT score ≥8 points) and pathological s-CDT had a reduction in both parameters (P=0.004 and P=0.063, respectively). Pain score according to M-ANNHEIM was unchanged, whereas use of analgesics decreased (P=0.005). Conclusions This feasibility study of patients with chronic pancreatitis demonstrated that multidisciplinary management seems to give a positive and sustainable effect on alcohol abuse and may be a useful concept for optimal classification, selection and treatment of patients with chronic pancreatitis.
Margareta B Lang , Ralf Segersvärd , Måns Grundsten , Märta Segerdahl , Urban Arnelo , Johan Permert , Johan Franck , Matthias Löhr , Jon A Tsai