EFFECT OF ALCOHOL AND SMOKING ON PANCREATIC LITHOGENESIS IN THE COURSE OF CHRONIC-PANCREATITIS

The aim of the study was to establish whether correlations were discer nible between calcification, smoking, and other variables-including al cohol intake-in chronic pancreatitis. A total of 637 patients with chr onic pancreatitis diagnosed over the period of 1973-1989 were reviewed . Only patients who had had one or more instrumental tests (ultrasonog raphy, endoscopic retrograde cholangiopancreatography, computed tomogr aphy, plain film of the abdomen) every 3 years were included in the st udy. Onset of calcification was taken as the end point of the follow-u p. No statistically significant correlation was found between alcohol intake and calcification. As regards smoking habits, patients were div ided into two groups: nonsmokers and medium-to-heavy smokers (greater- than-or-equal-to 10 cigarettes/day). Of 637 patients, only 570 fulfill ed our criteria. Three hundred seventy-six patients (66%) developed ca lcifications, whereas 64 (10%) already presented calcifications at the time of diagnosis. Smoking correlated with formation of calcification s (p < 0.004). The mean time to onset of calcification in smokers was 8 years as against 12 years in nonsmokers. The relative risk of calcif ication in smokers versus nonsmokers was 1.21 (95% confidence limits: 1.10-1.32). By the end of follow-up (17 years), 277 smokers (69%) with chronic pancreatitis had developed calcifications compared with only 93 nonsmokers (55%). The results show that, in this sample of chronic pancreatitis sufferers, smokers present a significantly increased risk of developing calcifications.