The natural course of chronic pancreatitis (CP), which is mostly caused by alcohol, is widely variable from individual to individual. Ammann et al. studied the disease in a large collective of 254 patients during a median follow-up of 10.4 years. Most of the patients who showed calcifications of the organ (85%) improved spontaneously after 4.5 years and did not require further intervention. About 50-60% of all patients with CP develop complications and need endoscopic or surgical intervention. The optimal management of the disease is still subject to debate. National and international guidelines lack evidence from randomized controlled prospective trials addressing the outcome and reach only low grades of recommendation.
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