Recently, the TIGAR-O classification of chronic pancreatitis was devised to categorize the various known risk factors . This classification is based on the idea that multiple genetic and environmental cofactors interact even in a case of chronic pancreatitis with an identified etiology. Hence, the histological characteristics based on etiology, as mentioned above, may be further subdivided or differentiated according to such cofactors interacting in the progression of pancreatitis.
As mentioned above, observation of the pathological courses and changes in each type of pancreatitis gives important information to clarify the pathogenesis. For example, histological differences of CAP from obstructive pancreatitis, such as interlobular-oriented fibrosis and frequent protein plug formation in ducts, may suggest that duct obstruction caused by protein plugs is not the main factor in the genesis of alcoholic pancreatitis .
This gives us abundant and valuable messages to continue careful observation and to identify the histopathological differences according to the interacting etiologies and cofactors. It helps not only in the clarification of pathogenesis, but also for pre-recognition of the clinical course, and deciding on the therapeutic approach.
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