Predictive factors for pseudocysts and peripancreatic collections in acute pancreatitis.

Background: Acute pancreatitis (AP) is a proteiform disease which may lead to various complications. Pancreatic pseudocysts and fluid collections are among the most frequent of them. The aim of our study was to find predictive factors of their occurrence.

Methods: We carried out a retrospective cohort study comprising one year patients admitted to our department with AP. Fisher's exact and U Mann Whitney tests were used for correlations, with a probability of error < 5% (p<0.05).

Results: We included 62 patients with a mean age of 49 years; 77.4% were males. AP etiology was due to alcohol (58.1%), biliary disorders (22.6%), hyper-triglycerides (8.1%) and post-ERCP (3.2%). Pancreatic cancer was revealed in (6.5%) patients. From the whole group 2 patients (3.2%) died. There were 22 patients with pseudocysts (35.5%) and 13 patients with acute fluid collections (21%). Multiple pseudocysts were present in 12 cases (54.5%), mean diameter was 39.5 mm. Pancreatic head localization was most frequent (63.6%). Alcoholic etiology was associated with acute pseudocysts formation (p=0.007) as well as lower values of alkaline phosphatase (96 U/L versus 286 U/L, p = 0.016). The area under the receiver operating characteristics curve demonstrated values of alkaline phosphatase < 2 x upper normal values were predicting pseudocyst occurrence with > 90% specificity. Presence of ascites predicted formation of acute fluid collections, (p < 0.001).

Conclusions: Alcoholic etiology and low values of serum alkaline phosphatase seem to predict pseudocysts formation in acute pancreatitis, while ascites forecast acute fluid collections occurrence.