{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T22:21:15Z","timestamp":1788733275957,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Chronic pancreatitis (CP) is an irreversible and progressive inflammation of the pancreas that can involve both pancreatic parenchyma and the pancreatic duct. CP results in morphological changes in the gland in the form of fibrosis and calcification along with functional impairment in the form of exocrine and endocrine insufficiency. Studies on the natural history of CP reveal the irreversibility of the condition and the resultant plethora of complications, of which pancreatic adenocarcinoma is the most dreaded one. In Japanese population-based studies by Otsuki and Fuzino et al., CP was clearly shown to reduce lifespan among males and females by 10.5 years and 16 years, respectively. This dismal prognosis is superadded to significant morbidity due to pain and poor quality of life, creating a significant burden on health and health-related infrastructure. These factors have led researchers to conceptualize early CP, which, theoretically, is a reversible stage in the disease spectrum characterised by ongoing pancreatic injury with the presence of clinical symptoms and the absence of classical imaging features of CP. Subsequently, the disease is thought to progress through a compensated stage, a transitional stage, and to culminate in a decompensated stage, with florid evidence of the functional impairment of the gland. In this focused review, we will discuss the definition and concept of early CP, the risk factors and natural history of the development of CP, and the role of various modalities of EUS in the timely diagnosis of early CP.<\/jats:p>","DOI":"10.3390\/diagnostics14030298","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T05:14:32Z","timestamp":1706591672000},"page":"298","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Role of Endoscopic Ultrasound in Early Chronic Pancreatitis"],"prefix":"10.3390","volume":"14","author":[{"given":"Jimil","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhirup","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truptesh H.","family":"Kothari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14642, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1111\/j.1572-0241.1999.01075.x","article-title":"Incidence of Cancer in The Course of Chronic Pancreatitis","volume":"94","author":"Talamini","year":"1999","journal-title":"Am. J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1136\/gut.51.6.849","article-title":"Risk of pancreatic adenocarcinoma in chronic pancreatitis","volume":"51","author":"Malka","year":"2002","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1007\/s00535-010-0242-4","article-title":"The revised Japanese clinical diagnostic criteria for chronic pancreatitis","volume":"45","author":"Shimosegawa","year":"2010","journal-title":"J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s00535-014-1016-1","article-title":"JSGE Clinical Practice Guidelines 2014: Standards, methods, and process of developing the guidelines","volume":"50","author":"Yoshida","year":"2015","journal-title":"J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/00006676-199405000-00014","article-title":"Alcoholic nonprogressive chronic pancreatitis: Prospective long-term study of a large cohort with alcoholic acute pancreatitis (1976\u20131992)","volume":"9","author":"Ammann","year":"1994","journal-title":"Pancreas"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.pan.2018.05.008","article-title":"International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club","volume":"18","author":"Whitcomb","year":"2018","journal-title":"Pancreatology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.gie.2008.07.043","article-title":"EUS-based criteria for the diagnosis of chronic pancreatitis: The Rosemont classification","volume":"69","author":"Catalano","year":"2009","journal-title":"Gastrointest. Endosc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1038\/ajg.2010.274","article-title":"Endoscopic ultrasound, secretin endoscopic pancreatic function test, and histology: Correlation in chronic pancreatitis","volume":"105","author":"Albashir","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.gie.2006.12.043","article-title":"Histopathologic correlates of noncalcific chronic pancreatitis by EUS: A prospective tissue characterization study","volume":"66","author":"Varadarajulu","year":"2007","journal-title":"Gastrointest. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1007\/s00535-020-01704-9","article-title":"Nationwide epidemiological survey of chronic pancreatitis in Japan: Introduction and validation of the new Japanese diagnostic criteria 2019","volume":"55","author":"Masamune","year":"2020","journal-title":"J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1038\/s41598-020-80532-6","article-title":"Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: A cross-sectional multicentre international study with experimental animal model","volume":"11","author":"Hegyi","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1038\/ajg.2009.405","article-title":"Natural history of acute pancreatitis: A long-term population-based study","volume":"104","author":"Lankisch","year":"2009","journal-title":"Am. J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1001\/archinternmed.2009.125","article-title":"Alcohol Consumption, Cigarette Smoking, and the Risk of Recurrent Acute and Chronic Pancreatitis","volume":"169","author":"Yadav","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1097\/MPA.0b013e3181b2bc1a","article-title":"Histopathologic Correlation of Endoscopic Ultrasound Findings of Chronic Pancreatitis in Human Autopsies","volume":"38","author":"Bhutani","year":"2009","journal-title":"Pancreas"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/S0016-5107(04)02018-8","article-title":"A prospective comparison of the yield of EUS in primary vs. recurrent idiopathic acute pancreatitis","volume":"60","author":"Yusoff","year":"2004","journal-title":"Gastrointest. Endosc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/j.cgh.2009.08.022","article-title":"Long-Term Prognosis of Acute Pancreatitis in Japan","volume":"7","author":"Takeyama","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1159\/000314599","article-title":"Chronic pancreatitis-like changes detected by endoscopic ultrasound in subjects without signs of pancreatic disease: Do these indicate age-related changes, effects of xenobiotics, or early chronic pancreatitis?","volume":"10","author":"Petrone","year":"2010","journal-title":"Pancreatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1007\/s00535-017-1311-8","article-title":"Nationwide epidemiological survey of early chronic pancreatitis in Japan","volume":"52","author":"Masamune","year":"2017","journal-title":"J. Gastroenterol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.pan.2018.08.002","article-title":"The diagnostic value of Rosemont and Japanese diagnostic criteria for \u2018indeterminate\u2019 \u2018suggestive\u2019 \u2018possible\u2019 and \u2018early\u2019 chronic pancreatitis","volume":"18","author":"Sheel","year":"2018","journal-title":"Pancreatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3820","DOI":"10.1007\/s00330-016-4720-9","article-title":"Diagnostic performance of imaging modalities in chronic pancreatitis: A systematic review and meta-analysis","volume":"27","author":"Issa","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.pan.2018.08.012","article-title":"Guidelines for the Diagnostic Cross Sectional Imaging and Severity Scoring of Chronic Pancreatitis","volume":"18","author":"Akisik","year":"2018","journal-title":"Pancreatology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/00365521.2017.1415372","article-title":"Quantification of parenchymal calcifications in chronic pancreatitis: Relation to atrophy, ductal changes, fibrosis and clinical parameters","volume":"53","author":"Andersen","year":"2018","journal-title":"Scand J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1148\/radiol.2018181353","article-title":"Reporting standards for chronic pancreatitis by using CT, MRI, and MR cholangiopancreatography: The consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer","volume":"290","author":"Tirkes","year":"2019","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4342","DOI":"10.3748\/wjg.v27.i27.4342","article-title":"Comprehensive review of diagnostic modalities for early chronic pancreatitis","volume":"27","author":"Ge","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1007\/s00261-016-0917-2","article-title":"Detection of exocrine dysfunction by MRI in patients with early chronic pancreatitis","volume":"42","author":"Tirkes","year":"2017","journal-title":"Abdom. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/jmri.26008","article-title":"Magnetic resonance elastography and T1 mapping for early diagnosis and classification of chronic pancreatitis","volume":"48","author":"Wang","year":"2018","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_27","first-page":"1002","article-title":"S3 guideline for chronic pancreatitis\u2014Diagnosis, classification and therapy for the radiologist","volume":"186","author":"Schreyer","year":"2004","journal-title":"RoFo Fortschritte Geb. Rontgenstrahlen Bildgeb. Verfahr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S0016-5107(05)00504-3","article-title":"EUS-guided Trucut biopsy of suspected nonfocal chronic pancreatitis","volume":"62","author":"DeWitt","year":"2005","journal-title":"Gastrointest. Endosc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/S0016-5107(01)70401-4","article-title":"The reliability of EUS for the diagnosis of chronic pancreatitis: Interobserver agreement among experienced endosonographers","volume":"53","author":"Wallace","year":"2001","journal-title":"Gastrointest. Endosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e164","DOI":"10.1002\/deo2.164","article-title":"Diagnosing chronic pancreatitis by endoscopic ultrasound assessing the association between ultrasound and pathological findings: A narrative review","volume":"3","author":"Yamamiya","year":"2023","journal-title":"DEN Open"},{"key":"ref_31","first-page":"221","article-title":"Endoscopic ultrasound in the diagnosis of chronic pancreatitis","volume":"107","author":"Lindkvist","year":"2015","journal-title":"Rev. Esp. Enfermedades Dig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/jgh.16047","article-title":"Lobularity rather than hyperechoic foci\/stranding on endoscopic ultrasonography is associated with more severe histological features in chronic pancreatitis","volume":"38","author":"Inomata","year":"2023","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1097\/MPA.0000000000001893","article-title":"A Comparative Study of Endoscopic Ultrasonography and Histopathology Images for the Diagnosis of Early Chronic Pancreatitis","volume":"50","author":"Sekine","year":"2021","journal-title":"Pancreas"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1055\/a-1217-3112","article-title":"Defining the endoscopic ultrasound features of chronic pancreatitis in Asians: A multicenter validation study","volume":"53","author":"Koh","year":"2021","journal-title":"Endoscopy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1055\/s-2007-1010405","article-title":"Prospective Evaluation of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in Patients with Chronic Abdominal Pain of Suspected Pancreatic Origin","volume":"25","author":"Wiersema","year":"1993","journal-title":"Endoscopy"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/MPA.0000000000000047","article-title":"Endoscopic Ultrasound and Histology in Chronic Pancreatitis","volume":"43","author":"LeBlanc","year":"2014","journal-title":"Pancreas"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1159\/000504780","article-title":"Validity of Endoscopic Ultrasound Findings of Chronic Pancreatitis: Evaluation from the Viewpoint of Disease Risk Factors","volume":"102","author":"Yamabe","year":"2019","journal-title":"Digestion"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"659","DOI":"10.5009\/gnl19170","article-title":"Utility of elastography with endoscopic ultrasonography shear-wave measurement for diagnosing chronic pancreatitis","volume":"14","author":"Yamashita","year":"2020","journal-title":"Gut Liver"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1055\/s-0033-1344614","article-title":"Quantitative elastography associated with endoscopic ultrasound for the diagnosis of chronic pancreatitis","volume":"45","year":"2013","journal-title":"Endoscopy"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1007\/s00535-016-1296-8","article-title":"Quantitative diagnosis of chronic pancreatitis using EUS elastography","volume":"52","author":"Kuwahara","year":"2017","journal-title":"J. Gastroenterol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/jgh.15137","article-title":"Endoscopic ultrasonography shear wave as a predictive factor of endocrine\/exocrine dysfunction in chronic pancreatitis","volume":"36","author":"Yamashita","year":"2020","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1177\/2050640620936810","article-title":"Endoscopic ultrasound-based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis","volume":"8","author":"Nieto","year":"2020","journal-title":"United Eur. Gastroenterol. J."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/3\/298\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:51:40Z","timestamp":1760104300000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/3\/298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,30]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["diagnostics14030298"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14030298","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,30]]}}}