BACKGROUND: The present study reports functional and morphological changes noted over long-term follow-up in patients with severe acute pancreatitis. METHODS: Thirty patients who had completed at least 6 months after recovery were included. Fecal fat, urinary D-xylose, blood sugar, C-peptide, pancreatic changes, and recurrences were studied. RESULTS: Etiology was gallstones (12), alcohol (10), both gallstone and alcohol (3), and idiopathic (5). Five patients were managed conservatively while 25 underwent surgery. Mean follow-up was 31.3 months. Exocrine and endocrine insufficiencies were noted in 12 (40%) and were more common in no-necrosis group compared to necrosis group (p = 0.04 and 0.28, respectively) and infected compared to sterile pancreatitis (45% vs. 25%, p = 0.55 and 50% vs. 12%, p = 0.15, respectively). Higher frequency was noted in nonvisualized, partly visualized, and dilated segment of duct. Significant proportion (8/12) had both exocrine and endocrine abnormalities and their incidence decreased as duration of follow-up increased. Urinary D-xylose excretion was abnormal in 16% and noted >1 year postrecovery. Thirty percent required >1 readmission and pain was the commonest cause. CONCLUSIONS: Forty percent had functional abnormality; 16% had mucosal absorption abnormality while 30% required >1 readmission. Exocrine and endocrine insufficiencies were more prevalent in first year, and a significant proportion had both. A trend for higher functional insufficiency was observed in infected necrosis, complete or incomplete visualization of main pancreatic duct (MPD), dilated segment of MPD, and pseudocyst.
BACKGROUND: The present study reports functional and morphological changes noted over long-term follow-up in patients with severe acute pancreatitis. METHODS: Thirty patients who had completed at least 6 months after recovery were included. Fecal fat, urinary D-xylose, blood sugar, C-peptide, pancreatic changes, and recurrences were studied. RESULTS: Etiology was gallstones (12), alcohol (10), both gallstone and alcohol (3), and idiopathic (5). Five patients were managed conservatively while 25 underwent surgery. Mean follow-up was 31.3 months. Exocrine and endocrine insufficiencies were noted in 12 (40%) and were more common in no-necrosis group compared to necrosis group (p = 0.04 and 0.28, respectively) and infected compared to sterile pancreatitis (45% vs. 25%, p = 0.55 and 50% vs. 12%, p = 0.15, respectively). Higher frequency was noted in nonvisualized, partly visualized, and dilated segment of duct. Significant proportion (8/12) had both exocrine and endocrine abnormalities and their incidence decreased as duration of follow-up increased. Urinary D-xylose excretion was abnormal in 16% and noted >1 year postrecovery. Thirty percent required >1 readmission and pain was the commonest cause. CONCLUSIONS: Forty percent had functional abnormality; 16% had mucosal absorption abnormality while 30% required >1 readmission. Exocrine and endocrine insufficiencies were more prevalent in first year, and a significant proportion had both. A trend for higher functional insufficiency was observed in infected necrosis, complete or incomplete visualization of main pancreatic duct (MPD), dilated segment of MPD, and pseudocyst.
Authors: F Senegas-Balas; M J Bastie; D Balas; J Escourrou; G Bommelaer; C Bertrand; Y Arany; A Ribet Journal: Dig Dis Sci Date: 1982-10 Impact factor: 3.199
Authors: L Sabater; E Pareja; L Aparisi; J Calvete; B Camps; J Sastre; E Artigues; M Oviedo; R Trullenque; S Lledó Journal: Pancreas Date: 2004-01 Impact factor: 3.327
Authors: Miroslav Vujasinovic; Bojan Tepes; Jana Makuc; Sasa Rudolf; Jelka Zaletel; Tjasa Vidmar; Maja Seruga; Bostjan Birsa Journal: World J Gastroenterol Date: 2014-12-28 Impact factor: 5.742
Authors: Stephanie L M Das; James I C Kennedy; Rinki Murphy; Anthony R J Phillips; John A Windsor; Maxim S Petrov Journal: World J Gastroenterol Date: 2014-12-07 Impact factor: 5.742
Authors: Chandraprakash Umapathy; Amit Raina; Shreyas Saligram; Gong Tang; Georgios I Papachristou; Mordechai Rabinovitz; Jennifer Chennat; Herbert Zeh; Amer H Zureikat; Melissa E Hogg; Kenneth K Lee; Melissa I Saul; David C Whitcomb; Adam Slivka; Dhiraj Yadav Journal: J Gastrointest Surg Date: 2016-09-12 Impact factor: 3.452
Authors: Thomas K Maatman; Alexandra M Roch; Eugene P Ceppa; Jeffrey J Easler; Mark A Gromski; Michael G House; Attila Nakeeb; C Max Schmidt; Stuart Sherman; Nicholas J Zyromski Journal: Surgery Date: 2020-08-22 Impact factor: 3.982
Authors: Bonna Leerhøy; Daniel M Shabanzadeh; Andreas Nordholm-Carstensen; Srdan Novovic; Mark B Hansen; Lars N Jørgensen Journal: United European Gastroenterol J Date: 2017-11-09 Impact factor: 4.623
Authors: Igor E Khatkov; Igor V Maev; Sayyar R Abdulkhalov; Sergey A Alekseenko; Ruslan B Allikhanov; Igor G Bakulin; Natalia V Bakulina; Andrey U Baranovskiy; Ekaterina V Beloborodova; Elena A Belousova; Sergey E Voskanyan; Lyudmila V Vinokurova; Vladimir B Grinevich; Vladimir V Darvin; Elena A Dubtsova; Tatiana G Dyuzheva; Vyacheslav I Egorov; Mikhail G Efanov; Roman E Izrailov; Vyacheslav L Korobka; Bogdan N Kotiv; Nikolay Yu Kokhanenko; Yury A Kucheryavy; Maria A Livzan; Vladimir K Lyadov; Karine A Nikolskaya; Marina F Osipenko; Victor D Pasechnikov; Ekaterina Yu Plotnikova; Oleg A Sablin; Vladimir I Simanenkov; Victor V Tsvirkun; Vladislav V Tsukanov; Alexey V Shabunin; Dmitry S Bordin; Professional Medical Society Pancreatic Club Russia Journal: Turk J Gastroenterol Date: 2021-03 Impact factor: 1.852