Complications of Pancreatitis-Knowledge Gaps and Research Opportunities: A Workshop Summary.

Jami L Saloman, Dana K Andersen, Maisam Abu-El-Haija, Melena D Bellin, Darwin L Conwell, Mahya Faghih, Christopher E Forsmark, Mark O Goodarzi, Aiste K Gulla, Phil A Hart, Steven J Hughes, Braden Kuo, Jennifer M Ladd, Bomi Lee, Stephen J Pandol, Anna Evans Phillips, Kristen M Roberts, Sarah Jane Schwarzenberg, Vikesh K Singh, Ronald M Summers, Temel Tirkes, Frederico G S Toledo, Guru Trikudanathan, Aliye Uc, Clive H Wasserfall, David C Whitcomb, Dhiraj Yadav, Christine Yost, Wenying Zhang, A Jay Freeman

Journal: Pancreas 2026;55(3):e267-e277

PMID: 41668344

Full Text on Wolters Kluwer View on PubMed

Abstract

Endocrine and exocrine insufficiencies are well-recognized pancreatic-specific sequelae of chronic pancreatitis (CP), yet the impact of CP extends beyond the pancreas. The pathophysiology driving these complications is complex and poorly understood, resulting in inadequate recognition and an inability to stratify risk of disease progression. To address this topic, the Collaborative Alliance for Pancreatic Education and Research convened a workshop to summarize our current understanding and identify knowledge gaps related to the complications of CP. The clinical uncertainty related to who will develop systemic complications of CP, and when, negatively affects the patient's clinical experience and is an area of research that requires additional commitment. Adapting modeling strategies proven effective in other conditions (eg, type 2 diabetes) may be effective in identifying and predicting the onset of endocrine and exocrine insufficiencies. Improved understanding related to genetic risk factors, biomarkers, clinical testing, and advanced imaging techniques all represent pathways to better identify these complications and develop pancreatitis-specific interventions. Additional complications of CP, including pain, osteopathies, sarcopenia, malnutrition, and visceral neuropathies, can occur independently or as complications from endocrine and/or exocrine insufficiency. Better screening strategies to identify these conditions are required, many of which may be accomplished using opportunistic screening strategies. Future research will need to utilize existing treatment modalities and medications, in addition to developing new interventions, to treat these complications of CP that have a tremendous impact on patients' quality of life. Genetic testing in pancreatitis is likely to inform any research related to the complications of CP, but low penetrance of disease, poor genotype-phenotype associations, and health disparities that impact the use of testing across centers currently limit its clinical utility for all patients. Genetic testing remains critical in certain populations with CP and should be incorporated into research whenever possible to inform much-needed disease progression prediction models.

Address: Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA.; Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA.; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.; Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH.; Departments of Pediatrics and Surgery, University of Minnesota and Masonic Children's Hospital, Minneapolis, MN.; Department of Medicine, University of Kentucky, Lexington, KY.; Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.; Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL.; Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA.; Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC.; Division of Gastroenterology, Hepatology, and Nutrition, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.; Division of Surgical Oncology, University of Florida, Gainesville, FL.; Center for Neurointestinal Health, Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Section of Endocrinology & Diabetes, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.; Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, School of Medicine, Stanford University, Stanford.; Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA.; Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA.; Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH.; Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, MHealth Fairview Masonic Children's Hospital, University of Minnesota, Minneapolis, MN.; Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center, National Institutes of Health, Bethesda, MD.; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN.; Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA.; Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN.; Stead Family Department of Pediatrics, University of Iowa, Stead Family Children's Hospital, IA.; Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL.; Department of Medicine Emeritus, University of Pittsburgh, Pittsburgh, PA.; Patient participant.; Pancreas and Liver Care Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.

DOI: 10.1097/MPA.0000000000002574

Link outs

Free resources

Miscellaneous:

https://assays.cancer.gov/CPTAC-660

Subscription / membership required

Full Text Sources:

https://doi.org/10.1097/MPA.0000000000002574

MeSH Terms: Humans, Pancreatitis, Chronic, Biomedical Research, Exocrine Pancreatic Insufficiency, Risk Factors, Pancreatitis