Today in medicine there are more than 40 different classifications of chronic pancreatitis. This circumstance led to a significant difficulty in the treatment, pathogenesis, clinic and diagnosis of this pancreatic disease.
Most often, the Marseilles-Romean classification, adopted back in 1988, is now used. In its essence, this is a slightly modified classification, approved in Marseille in 1983.The adoption of unified international classifications such as ICD 10 is very important in the exchange of experience in diagnosis and treatment among specialists from different countries. For example, at the second International Symposium in 1983, held in Marseille, experts decided to abandon the separation of two forms of chronic pancreatitis: recurrent from acute. This decision was made because of the high complexity in the division of these diseases into practice.
Of all the forms of this disease and its aggravation, it was decided to allocate only two:
- Chr.pancreatitis with diffuse or segmental fibrosis, focal necrosis in combination with: 1) the formation of a cyst, inflammatory infiltration;2) deformation or expansion of the gland system;3) formation of calcinates.
- Chr.obstructive pancreatitis, which is characterized by deformation or expansion of the duct system, diffuse fibrosis and atrophy of the parenchyma.
If the clinical symptomatology of the chronic form is considered, the following classification is used:
- Subclinical or latent chronic obstructive pancreatitis characterized by morphological changes in the gland and a pancreatic function disorder without clear clinical symptoms of the disease.
- Chronic painful obstructive pancreatitis, in which there are permanent or periodic abdominal pains.
- Chronic painless obstructive pancreatitis, which occurs in combination with endocrine or exocrine gland failure, and often with complications.
The Marseille classification of 1983 has many advantages, but in medical practice its use is almost impossible. The point is that for its use it is necessary to perform a biopsy of the gland and ERCPH, and the subsequent histological examination.
This situation led to the need for a new international classification of the disease. For example, according to the ICD 10, chronic pancreatitis is divided into 2 categories according to the etiology of the disease:
- Alcoholic - code K86.0;
- Other pancreatitis - code K86.1.