A single-centre prospective, cohort study of the natural history of acute pancreatitis

被引：44

作者：

Cavestro, Giulia Martina ^{[1
,2
]}

Leandro, Gioacchino ^{[3
]}

Di Leo, Milena ^{[1
,2
]}

Zuppardo, Raffaella Alessia ^{[1
,2
]}

Morrow, Olivia B. ^{[2
]}

Notaristefano, Chiara ^{[1
]}

Rossi, Gemma ^{[1
,2
]}

Testoni, Sabrina Gloria Giulia ^{[1
,2
]}

Mazzoleni, Giorgia ^{[1
,2
]}

Alessandri, Matteo ^{[1
,2
]}

Goni, Elisabetta ^{[2
]}

Singh, Satish K. ^{[4
,5
]}

Giliberti, Aurore ^{[3
]}

Bianco, Margherita ^{[3
]}

Fanti, Lorella ^{[1
]}

Viale, Edi ^{[1
]}

Arcidiacono, Paolo Giorgio ^{[1
]}

Mariani, Alberto ^{[1
]}

Petrone, Maria Chiara ^{[1
]}

Testoni, Pier Alberto ^{[1
,2
]}

机构：

[1] IRCCS San Raffaele Sci Inst, Div Expt Oncol, Gastroenterol & Gastrointestinal Endoscopy Unit, Milan, Italy

[2] Univ Vita Salute San Raffaele, Gastroenterol & Gastrointestinal Endoscopy Unit, I-20132 Milan, Italy

[3] Gastroenterol Hosp S De Bellis IRCCS, Gastroenterol Unit 1, Castellana Grotte, Italy

[4] Boston Univ, Sch Med, Boston, MA 02118 USA

[5] Boston Med Ctr, Gastroenterol Sect, I-20132 Milan, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2015年 / 47卷 / 03期

关键词：

Acute pancreatitis; Alcohol and smoking habits; Chronic pancreatitis; Pancreas divisum; Recurrent acute pancreatitis; Severe acute disease; MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY; ACUTE RECURRENT; EARLY-STAGE; CFTR GENE; DIVISUM; DIAGNOSIS; DISEASE; CLASSIFICATION; ABNORMALITIES; ASSOCIATION;

D O I：

10.1016/j.dld.2014.11.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: The natural history of acute pancreatitis is based on clinical studies that aim to elucidate the course of disease on the basis of predicted risk factors. Aims: To evaluate the long-term occurrence of recurrent acute pancreatitis and chronic pancreatitis in a cohort of patients following an initial episode of acute pancreatitis. Methods: 196 patients were enrolled consecutively and studied prospectively. Clinical characteristics, exogenously/endogenously-associated factors, and evolution to recurrent acute pancreatitis and chronic pancreatitis were analyzed. Results: 40 patients developed recurrent acute pancreatitis 13 of whom developed chronic pancreatitis. In a univariate analysis, recurrent acute pancreatitis was associated with an idiopathic aetiology (p < 0.001), pancreas divisum (p = 0.001), and higher usage of cigarettes and alcohol (p < 0.001; p = 0.023). Chronic pancreatitis was associated with a severe first episode of acute pancreatitis (p = 0.048), PD (p = 0.03), and cigarette smoking (p = 0.038). By multivariate analysis, pancreas divisum was an independent risk factor for recurrent acute pancreatitis (OR 11.5, 95% CI 1.6-83.3). A severe first-episode of acute pancreatitis increased the risk of progressing to chronic pancreatitis by nine-fold. Conclusions: Special attention should be given to patients who experience a severe first attack of acute pancreatitis as there appears to be an increased risk of developing chronic pancreatitis over the long term. (C) 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

引用

页码：205 / 210

页数：6

共 45 条

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