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

Dig Liver Dis. 2018 Mar;50(3):277-282. doi: 10.1016/j.dld.2017.12.011. Epub 2017 Dec 19.

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.

Keywords: Acute pancreatitis; Biliary acute pancreatitis; ERCP; Recurrence.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Alcohol Drinking / epidemiology
  • Cholangiopancreatography, Endoscopic Retrograde / statistics & numerical data
  • Cholecystectomy / statistics & numerical data
  • Disease Progression*
  • Female
  • Follow-Up Studies
  • Humans
  • Italy / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pancreatitis / epidemiology*
  • Pancreatitis / etiology*
  • Pancreatitis / therapy
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Treatment Failure