Buchler et al developed a classification system for staging patients with chronic pancreatitis. The authors are from the University of Heidelberg, Technical University Munich and Otto von Guericke University in Magdeburg.
Patient selection: chronic pancreatitis
Clinical and imaging findings:
(1) pain
(2) recurrent attacks of acute pancreatitis
(3) complications of chronic pancreatitis
(4) steatorrhea
(5) diabetes mellitus
(6) CT, MRI, ultrasound, endoscopic ultrasonography, and/ERCP
Complications:
(1) bile duct obstruction/stenosis with cholestasis or jaundice
(2) duodenal obstruction/stenosis
(3) vascular obstruction/stenosis involving portal and/or splenic vein
(4) pancreatic pseudocysts
(5) pancreatic fistula
(6) pancreatogenic ascites
(7) other rare complications in adjacent organs (colon stenosis, splenic pseudocyts, etc)
Finding
|
Stage A
|
Stage B
|
Stage C
|
pain and/or acute pancratitis
|
one or both
|
NA
|
NA
|
complications
|
absent
|
present
|
variable
|
steatorrhea
|
absent
|
absent
|
variable
|
insulin-dependent diabetes mellitus
|
absent
|
absent
|
variable
|
Stage C may be divided into:
C1: diabetes mellitus (endocrine function impairment)
C2: steatorrhea (exocrine function impairment)
C3: both diabetes and steatorrhea AND/OR complications
The system uses the following scheme for reporting:
chronic pancreatitis (), stage,