Decision making in pancreatology, Latvia experience

The accuracy of chronic pancreatitis (CP) diagnosis in an individual patient depends on a number of factors such as clinical awareness of possibility of the diagnosis, decision making skills. Last decade studies showed an increase in the incidence of CP both in urban and country areas (population in Latvia is 2,625 mil.). Around 20-25 new cases per 100000 are registered last year with a tendency to grow. The main risk factors that have been reported are increased alcohol intake and biliary stones. The mortality rate (MR) from pancreatic diseases is higher for elderly patients in an age 65-70. An increase of MR from 3,9 to 4,5 per 100000 persons was recorded during a one year period (1998-1999). 33% (p<0,05) of all malignancies were obtained under the mask of other diseases. In 56% cases patient visit was too late. Last year the Pancreas Problem Group was founded at the Latvia Gastroenterologists Association. New recommendations on CP diagnostics and treatment were elaborated according to our local needs and international experience. The project was targeted to the general practitioners internists and gastroenterology specialists. General aim was to improve the pancreatic patient management, decision making, early diagnostic and treatment possibilities. Special importance was focused on the CP diagnostic criteria. This project showed the importance of CP as a problem in the whole country. To improve the situation, it is substantiated to continue the specialists and patient education.