AI Article Synopsis
- Most cases of acute pancreatitis come from gallbladder issues, and surgery (cholecystectomy) is typically recommended to avoid recurrence, but some patients don't get referred for surgery.
- A study analyzed 104 patients with biliary pancreatitis who didn’t have surgery from 2015 to 2017, examining their health outcomes and complications over an average follow-up of 37 months.
- Results showed significant complications, such as recurrent pancreatitis (22.1%) and other biliary events (32.7%), with 24% mortality during follow-up, though only a small percentage (5.8%) died from gallstone-related issues, suggesting that surgery decisions should be tailored for patients with multiple health issues.
Article Abstract
Background And Objective: most acute pancreatitis cases are of biliary origin and cholecystectomy is recommended to prevent recurrence. However, some patients will never be referred for surgery. In this study, the long-term follow-up of this group of patients was reviewed.
Methods: all new cases of biliary pancreatitis from January 2015 to December 2017 that did not undergo cholecystectomy were analyzed. Epidemiologic data and Charlson's comorbidity index (CCI) were recorded. Recurrent episodes of pancreatitis or biliary events and mortality during the follow-up period were recorded.
Results: a total of 104 patients were included in the study (30.4 % of all biliary pancreatitis cases) and the median age was 82 years (range, 27-96). Average CCI was 5 (range, 0-18) and the median follow-up period was 37 months (range, 1-70). A total of 41 patients (39.4 %) had gallstone-related complications. Twenty-three patients (22,1 %) had recurrent pancreatitis and 34 (32,7 %) developed biliary events. Twenty-five patients died during follow-up (24 %) but only in 6 (5,8 %) was death due to gallstone-related complications. Non-related mortality was 15.5 % in patients who refused surgery and 25 % in multiple-comorbidity patients.
Conclusion: patients who did not undergo cholecystectomy were at high risk for biliary events and pancreatitis recurrence. Conservative treatment and surgical abstention should be individualized and reserved for patients with multiple comorbidities with a short life expectancy.
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| http://dx.doi.org/10.17235/reed.2021.7891/2021 | DOI Listing |
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