NATURAL-HISTORY OF NONALCOHOLIC CHRONIC-PANCREATITIS - A STUDY OF 37 CASES AND A COMPARISON WITH 319 CASES OF ALCOHOLIC CHRONIC-PANCREATITIS

We studied the etiology, complications, need for surgical treatment and survival in patients with non-alcoholic chronic pancreatitis (n = 37, including 5 familial, 2 postradiation and 30 idiopathic cases of pancreatitis) and with alcoholic chronic pancreatitis (n = 319). The median follow-up was 6 years. There was a higher frequency of onset of the disease in the fourth decade in alcoholic patients and a more regular pattern with a peak in the third decade in the non-alcoholic patients. The comparison between the two groups showed, in non-alcoholic patients: a lower M/F ratio (non-alcoholics: 1, alcoholics: 9; P < 0.0001), less smokers (P < 0.0001), a lower cumulative probability for development of pancreatic calcification (P < 0.02), insulin-dependent diabetes mellitus (P < 0.02) and pseudocysts (P < 0.01). Frequency and type of surgery were not different in the 2 groups. The observed survival of non-alcoholic patients was better than the observed survival in alcoholic patients and than the expected survival in a matched French population. Conclusions: in this study, non-alcoholic chronic pancreatitis accounted for 10.4 % of the disease; the comparison to alcoholic chronic pancreatitis shows that it is the same, however less evolutive, disease. Chronic pancreatitis by itself has no major influence on vital prognosis.