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RESEARCH PRODUCT
Recurrence of Acute Gallstone Pancreatitis and Relationship with Cholecystectomy or Endoscopic Sphincterotomy
Adolfo BenagesIsabel PascualMiguel MinguezVicent HernandezBelen HerrerosPedro AlmelaR AñónVicente Sanchizsubject
Malemedicine.medical_specialtyPancreatic diseasemedicine.medical_treatmentGallstonesSeverity of Illness IndexSphincterotomy EndoscopicRecurrenceRisk FactorsSeverity of illnessPrevalenceHumansMedicineCholecystectomyProspective StudiesProspective cohort studyAgedChi-Square DistributionHepatologymedicine.diagnostic_testbusiness.industryGallbladderGeneral surgeryGastroenterologyMiddle AgedPrognosismedicine.diseaseSurgeryEndoscopyLogistic Modelsmedicine.anatomical_structurePancreatitisAcute DiseasePancreatitisFemaleCholecystectomybusinessChi-squared distributiondescription
To determine the prevalence of recurrence of gallstone pancreatitis, its clinical features, and the presence of prognostic factors of recurrence.From January 1, 2000 to August 31, 2003, 233 patients admitted with acute gallstone pancreatitis (AGP) were prospectively studied. Patients were divided into two groups: recurrent and nonrecurrent group. Clinical, analytical, radiological, prognostic parameters, and severity (Atlanta criteria) were assessed, along with the performance of cholecystectomy or endoscopic sphincterotomy (ES). Clinical features of recurrence were analyzed. Univariate (chi(2), Student's t-test) and multivariate tests were performed. Statistical significance was assumed if p0.05.Two hundred and eighty-six attacks were identified. Forty-two patients (18.2%) recurred, suffering 53 recurrent attacks, which took place within 30 days in 23.3%. Patients who did not undergo surgery after the first attack had 31-fold risk of recurrence (OR = 31.5%, CI = 95%[7.22-137.84], p0.001). In patients not operated, recurrence was more frequent if ES was not performed (37.04%vs 0%, p= 0.019). Among patients with surgical risk, none who recurred underwent ES, compared with 27.9% of those who did not recur. Patients in the nonrecurrent group underwent cholecystectomy within the first 30 days or ES more frequently (31.2%vs 7.3%, p= 0.001).Recurrence of gallstone pancreatitis is a frequent event. Delay of cholecystectomy implies an increased risk of recurrence. ES could be an acceptable option to prevent recurrence in patients who are not candidates for surgery or who do not desire to undergo cholecystectomy.
year | journal | country | edition | language |
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2004-12-02 | The American Journal of Gastroenterology |