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- Exclude alcohol or drug addiction, gallstones, pancreatitis-inducing medications, hyperparathyroidism, hypercalcemia, and hyperlipidemia

- Evaluate for steatorrhea and diabetes mellitus (glucose intolerance), especially the need for insulin

- Severity of pain (Likert visual analog pain scale completed by patient)

- Psychosocial stability

- Quality of life survey (optional)

- European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC)

- Medical Outcomes Trust Short-Form 36 (MOS SF-36)

- Impact of pain on employment, family support, daily activities

■ Clinical evaluation:

- Jaundice, ascites, nutritional status, weight, physiologic health, co-morbidities

- Baseline pancreatic exocrine and endocrine function if indicated

■ Laboratory tests:

- CA 19-9 (most useful if common bile duct patent), LFTs, HbAIC, glucose tolerance test

- Fecal fat and secretin studies are only required rarely

- Imaging

- Triphasic helical CT to evaluate for:

- Pancreatic masses

- Portal and left-sided hypertension or thrombosis of the splenic vein

- Involvement of adjacent organs

- Extrapancreatic causes of pancreatitis (cholelithiasis)

- ERCP to evaluate pancreatic and biliary ductal systems and esophagogastroduo-denoscopy to exclude peptic ulcer disease

- Endoscopic or intraoperative ultrasonography to evaluate for vascular involvement and biopsy if indicated

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