TY - JOUR
T1 - Gallstones as a cause in presumed acute alcoholic pancreatitis
T2 - observational multicentre study
AU - Sissingh, Noor J.
AU - de Rijk, Fleur E. M.
AU - Timmerhuis, Hester C.
AU - Umans, Devica S.
AU - Anten, Marie-Paule G. F.
AU - Bouwense, Stefan A. W.
AU - van Delft, Foke
AU - van Eijck, Brechje C.
AU - Erkelens, Willemien G.
AU - Hazen, Wouter L.
AU - Kuiken, Sjoerd D.
AU - Quispel, Rutger
AU - Romkens, Tessa E. H.
AU - Schwartz, Matthijs P.
AU - Seerden, Tom C.
AU - Spanier, B. W. Marcel
AU - Verlaan, Tessa
AU - Vleggaar, Frank P.
AU - Voermans, Rogier P.
AU - Verdonk, Robert C.
AU - van Hooft, Jeanin E.
AU - Dutch Pancreatitis Study Grp
PY - 2024/5/3
Y1 - 2024/5/3
N2 - Background: Data on the incidence and clinical relevance of gallstones in patients with suspected acute alcoholic pancreatitis are lacking and are essential to minimize the risk of recurrent acute pancreatitis. The aim of this study was to assess the incidence of gallstones and the associated rate of recurrent acute pancreatitis in patients with presumed acute alcoholic pancreatitis. Methods: Between 2008 and 2019, 23 hospitals prospectively enrolled patients with acute pancreatitis. Those diagnosed with their first episode of presumed acute alcoholic pancreatitis were included in this study. The term gallstones was used to describe the presence of cholelithiasis or biliary sludge found during imaging. The primary outcome was pancreatitis recurrence during 3 years of follow-up. Results: A total of 334 patients were eligible for inclusion, of whom 316 were included in the follow-up analysis. Gallstone evaluation, either during the index admission or during follow-up, was performed for 306 of 334 patients (91.6%). Gallstones were detected in 54 patients (17.6%), with a median time to detection of 6 (interquartile range 0-42) weeks. During follow-up, recurrent acute pancreatitis occurred in 121 of 316 patients (38.3%), with a significantly higher incidence rate for patients with gallstones compared with patients without gallstones (59% versus 34.2% respectively; P < 0.001), while more patients with gallstones had stopped drinking alcohol at the time of their first recurrence (41% versus 24% respectively; P = 0.020). Cholecystectomy was performed for 19 patients with gallstones (36%). The recurrence rate was lower for patients in the cholecystectomy group compared with patients who did receive inadequate treatment or no treatment (5/19 versus 19/34 respectively; P = 0.038). Conclusion: Gallstones were found in almost one in every five patients diagnosed with acute alcoholic pancreatitis. Gallstones were associated with a higher rate of recurrent pancreatitis, while undergoing cholecystectomy was associated with a reduction in this rate.
AB - Background: Data on the incidence and clinical relevance of gallstones in patients with suspected acute alcoholic pancreatitis are lacking and are essential to minimize the risk of recurrent acute pancreatitis. The aim of this study was to assess the incidence of gallstones and the associated rate of recurrent acute pancreatitis in patients with presumed acute alcoholic pancreatitis. Methods: Between 2008 and 2019, 23 hospitals prospectively enrolled patients with acute pancreatitis. Those diagnosed with their first episode of presumed acute alcoholic pancreatitis were included in this study. The term gallstones was used to describe the presence of cholelithiasis or biliary sludge found during imaging. The primary outcome was pancreatitis recurrence during 3 years of follow-up. Results: A total of 334 patients were eligible for inclusion, of whom 316 were included in the follow-up analysis. Gallstone evaluation, either during the index admission or during follow-up, was performed for 306 of 334 patients (91.6%). Gallstones were detected in 54 patients (17.6%), with a median time to detection of 6 (interquartile range 0-42) weeks. During follow-up, recurrent acute pancreatitis occurred in 121 of 316 patients (38.3%), with a significantly higher incidence rate for patients with gallstones compared with patients without gallstones (59% versus 34.2% respectively; P < 0.001), while more patients with gallstones had stopped drinking alcohol at the time of their first recurrence (41% versus 24% respectively; P = 0.020). Cholecystectomy was performed for 19 patients with gallstones (36%). The recurrence rate was lower for patients in the cholecystectomy group compared with patients who did receive inadequate treatment or no treatment (5/19 versus 19/34 respectively; P = 0.038). Conclusion: Gallstones were found in almost one in every five patients diagnosed with acute alcoholic pancreatitis. Gallstones were associated with a higher rate of recurrent pancreatitis, while undergoing cholecystectomy was associated with a reduction in this rate.
KW - IDIOPATHIC ACUTE-PANCREATITIS
KW - 2018 DIAGNOSTIC-CRITERIA
KW - ENDOSCOPIC ULTRASONOGRAPHY
KW - RECURRENT PANCREATITIS
KW - BILIARY MICROLITHIASIS
KW - RISK-FACTORS
KW - GUIDELINES
KW - DISEASE
KW - CLASSIFICATION
KW - EPIDEMIOLOGY
U2 - 10.1093/bjs/znae107
DO - 10.1093/bjs/znae107
M3 - Article
SN - 0007-1323
VL - 111
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 5
M1 - znae107
ER -