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Recurrence of Acute Gallstone Pancreatitis and Relationship with Cholecystectomy or Endoscopic Sphincterotomy
- Source :
- The American Journal of Gastroenterology. 99:2417-2423
- Publication Year :
- 2004
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2004.
-
Abstract
- 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.
- Subjects :
- Male
medicine.medical_specialty
Pancreatic disease
medicine.medical_treatment
Gallstones
Severity of Illness Index
Sphincterotomy, Endoscopic
Recurrence
Risk Factors
Severity of illness
Prevalence
Humans
Medicine
Cholecystectomy
Prospective Studies
Prospective cohort study
Aged
Chi-Square Distribution
Hepatology
medicine.diagnostic_test
business.industry
Gallbladder
General surgery
Gastroenterology
Middle Aged
Prognosis
medicine.disease
Surgery
Endoscopy
Logistic Models
medicine.anatomical_structure
Pancreatitis
Acute Disease
Female
business
Chi-squared distribution
Subjects
Details
- ISSN :
- 15720241 and 00029270
- Volume :
- 99
- Database :
- OpenAIRE
- Journal :
- The American Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....90c4f169bc6ebd861fcda81f911ee7af