Background: Data about recurrent acute pancreatitis (RAP) are limited. Aims: To evaluate the rate of RAP and associated factors. Methods: Single-centre prospective study of consecutive patients at first episode of acute pancreatitis (AP) being followed-up. Results: Of 266 consecutive AP patients, (47% biliary, 15.4% alcoholic, 14.3% idiopathic) 66 (24.8%) had RAP in a mean follow-up of 42 months; 17.9% of recurrences occurred within 30 days from discharge. Age, gender, smoking and severity of first AP were not associated with RAP risk. The rate of biliary RAP was 31.3% in patients who did not receive any treatment, 18% in those treated with ERCP only, 16% in those who received cholecystectomy only, and 0% in those treated both with surgery and ERCP. Patients with biliary AP who received cholecystectomy had a significantly longer time of recurrence-free survival and reduced recurrence risk (HR = 0.45). In patients with alcoholic AP, the rate of recurrence was lower in those who quit drinking (5.8% vs 33%; p = 0.05). The alcoholic aetiology was associated with a higher risk of having >2 RAP episodes. Conclusion: RAP occurs in about 25% of cases, and failure to treat biliary aetiology or quitting drinking is associated with increased recurrence risk.

Recurrent biliary acute pancreatitis is frequent in a real-world setting / Stigliano, S; Belisario, F; Piciucchi, M; Signoretti, M; Delle Fave, G; Capurso, G. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 50:3(2018), pp. 277-282. [10.1016/j.dld.2017.12.011]

Recurrent biliary acute pancreatitis is frequent in a real-world setting

Capurso G
2018-01-01

Abstract

Background: Data about recurrent acute pancreatitis (RAP) are limited. Aims: To evaluate the rate of RAP and associated factors. Methods: Single-centre prospective study of consecutive patients at first episode of acute pancreatitis (AP) being followed-up. Results: Of 266 consecutive AP patients, (47% biliary, 15.4% alcoholic, 14.3% idiopathic) 66 (24.8%) had RAP in a mean follow-up of 42 months; 17.9% of recurrences occurred within 30 days from discharge. Age, gender, smoking and severity of first AP were not associated with RAP risk. The rate of biliary RAP was 31.3% in patients who did not receive any treatment, 18% in those treated with ERCP only, 16% in those who received cholecystectomy only, and 0% in those treated both with surgery and ERCP. Patients with biliary AP who received cholecystectomy had a significantly longer time of recurrence-free survival and reduced recurrence risk (HR = 0.45). In patients with alcoholic AP, the rate of recurrence was lower in those who quit drinking (5.8% vs 33%; p = 0.05). The alcoholic aetiology was associated with a higher risk of having >2 RAP episodes. Conclusion: RAP occurs in about 25% of cases, and failure to treat biliary aetiology or quitting drinking is associated with increased recurrence risk.
2018
acute pancreatitis
biliary acute pancreatitis
ercp
recurrence
acute disease
adult
aged
alcohol drinking
cholangiopancreatography
endoscopic retrograde
cholecystectomy
female
follow-up studies
humans
italy
kaplan-meier estimate
male
middle aged
pancreatitis
prospective studies
recurrence
risk factors
treatment failure
disease progression
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/151845
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