P0039 - The Rate and Characteristics of Chronic Pancreatitis Without Prior Acute Pancreatitis: A Systematic Review and Meta-Analysis

Endre Botond Gagyi, MD, Mahmoud Obeidat, MD, Levente Frim, MD, Szilard Vancsa, MD, PhD, Peter Hegyi, MD, PhD, Balint Eross, MD, PhD
Centre for Translational Medicine, Semmelweis University, Budapest, Budapest, Hungary

Introduction: According to the sentinel acute pancreatitis event model (SAPE), chronic pancreatitis (CP) is believed to evolve from episodes of acute pancreatitis (AP). However, a significant proportion of CP cases emerge without any documented prior AP, challenging existing paradigms about the disease's pathogenesis.

This systematic review and meta-analysis aim to quantify the prevalence and characterize the profile of CP cases that manifest without preceding AP episodes.

Methods: We conducted a comprehensive search in Medline, Embase, and Cochrane databases up to February 13th, 2024. We included studies investigating the CP population where they reported the presence and absence of prior AP episodes. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using the random-effects model. Heterogeneity was evaluated using the I² statistic.

Results: Our analysis included data from 8 studies, comprising a total of 4060 patients diagnosed with CP. Of these, 30.2% (95% CI: 21.5%-40.4%) patients had no prior episodes of AP. We found the following factors associated with this population: a higher prevalence of diabetes mellitus (OR 1.71; 95% CI: 1.16-2.52; I²=80%), pancreatic stones (OR 1.85; 95% CI: 1.42-2.42; I²=0%), and lower rates of abdominal pain (OR 0.31; 95% CI: 0.20-0.47; I²=77%), pseudocysts (OR 0.48; 95% CI: 0.25-0.91; I²=79%), alcohol use (OR 0.64; 95% CI: 0.44-0.91; I²=71%), and smoking (OR 0.66; 95% CI: 0.47-0.94; I²=65%).

Discussion: Approximately one-third of CP patients have no history of AP episodes. Moreover, this subset of patients shows significant differences from other CP patients in several parameters.


Disclosures:


Endre Botond Gagyi, MD, Mahmoud Obeidat, MD, Levente Frim, MD, Szilard Vancsa, MD, PhD, Peter Hegyi, MD, PhD, Balint Eross, MD, PhD. P0039 - The Rate and Characteristics of Chronic Pancreatitis Without Prior Acute Pancreatitis: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.