Natural history of non alcoholic and non familial chronic pancreatitis. Results of a multicentre study.

The natural history and complications of non alcoholic chronic pancreatitis (NACP) is poorly understood compared to that of alcoholic chronic pancreat itis (ACP). Patients and Methods - From April 1993 to April 1996, 77 patients with NACP were prospectively evaluated in 17 French centres. This population was com pared to a cohort of 417 patients with ACP. Results - No significant difference was observed with respect to mean age b etween NACP and ACP (43 +/- 20 vs 44 +/- 11 years, respectively). The media n patient follow-up time was also comparable: 7 years (1-28) and 6 years (1 -34) respectively for NACP and ACP. There were significantly more males in the ACP group (9/1 in ACP group and 1.3/1 in NACP group: P < 10(-7)). Patie nts with NACP were less likely to have calcifications (58% vs 77%; P = 0.01 ), pseudocysts (19 vs 47%, P < 0.001), portal vein thrombosis (5 vs 16%, P < 0.02). Importantly, patients with NACP required less surgical procedures than those with ACP (26% vs 44%, P = 0.004). The actuarial death rate at 15 years was 0% in the NACP group compared to 20.5% in those with ACP (no CP related death). Conclusion - NACP has a less severe disease progression, fewer complication s and requires less surgical interventions than ACP. The lower actuarial su rvival rate in patients with ACP correlates with the extra-pancreatic compl ications encountered in patients with alcohol related diseases and not with the evolution of CP itself.