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

Cavestro, Giulia Martina; Leandro, Gioacchino; Leo, Milena Di; Zuppardo, Raffaella Alessia; Morrow, Olivia; Notaristefano, Chiara; Rossi, Gemma; Testoni, Sabrina Gloria Giulia; Mazzoleni, Giorgia; Alessandri, Matteo; Goni, Elisabetta; Singh, Satish K.; Giliberti, Aurore; Bianco, Margherita; Fanti, Lorella; Viale, Edi; Arcidiacono, Paolo Giorgio; Mariani, Alberto; Petrone, Maria Chiara; Testoni, Pier Alberto

doi:10.1016/j.dld.2014.11.003

Cited by 41 publications

(24 citation statements)

References 40 publications

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“…Th ere has been limited study of the etiology, diagnostic approach, and natural history following a single attack of idiopathic pancreatitis (24)(25)(26)(27). Prior studies suggest relapse rates varying from 14 to 24% (24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 95%

Prospective Endoscopic Ultrasound-Based Approach to the Evaluation of Idiopathic Pancreatitis: Causes, Response to Therapy, and Long-term Outcome

Wilcox

Seay

Kim

et al. 2016

American Journal of Gastroenterology

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OBJECTIVES:Although idiopathic pancreatitis is common, the natural history is not well studied, and the best diagnostic approach to both single and multiple attacks remains undefi ned. METHODS:We prospectively evaluated patients with idiopathic pancreatitis over a 10-year period, and clinical information for each episode was reviewed. Endoscopic ultrasound (EUS) was performed in all patients. Patients with microlithiasis or bile duct stones were referred for cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP), respectively. For those with a single attack, if EUS was normal or chronic pancreatitis or pancreas divisum was diagnosed, the patient was followed up for recurrence. For those with multiple attacks and a negative EUS, ERCP and sphincter of Oddi manometry with endoscopic therapy as appropriate were recommended. All patients were followed up in the long term to evaluate for recurrent pancreatitis, the primary study end point. RESULTS:Over the study period, 201 patients were identifi ed (80 single attack, 121 multiple attacks; mean age 53 years, range 17-95 years, s.d. 16.3 years; and 53% female). After EUS, 54% of patients with a single attack were categorized as idiopathic, and for multiple attacks sphincter of Oddi dysfunction (SOD) was the most common diagnosis (41%). Long-term follow-up (median 37 months; interquartile range 19-70 months) documented recurrence of pancreatitis in 15 (24%; 95% confi dence interval (CI), 15-38%) patients with a single attack and in 48 (49%; 95% CI, 38-62%) patients with multiple attacks. Despite endoscopic therapy, patients with pancreas divisum and SOD had relapse rates of 50% (95% CI, 35 to 68%) and 55% (95% CI, 31 to 82%), respectively. CONCLUSIONS: Following a single idiopathic attack of pancreatitis and a negative EUS examination, relapse was infrequent. Despite endoscopic therapy, patients with multiple attacks, especially those attributed to pancreas divisum and SOD, had high rates of recurrence. EUS may be a useful, minimally invasive tool for the diagnostic evaluation of idiopathic pancreatitis. The study was listed in Clinicaltrials.gov NCT00609726.

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Section: Discussionmentioning

confidence: 95%

Prospective Endoscopic Ultrasound-Based Approach to the Evaluation of Idiopathic Pancreatitis: Causes, Response to Therapy, and Long-term Outcome

Wilcox

Seay

Kim

et al. 2016

American Journal of Gastroenterology

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“…[18][19][20] Given the socioeconomic impact of CP, 22 alleviation and/or cessation of RAP with etiology-based treatment may have an impact on health care costs and patient morbidity. As discussed previously, endoscopic therapy has been studied as a management option specifically within the context of divisum-associated RAP and IRAP and is the focus of this article.…”

Section: Recurrent Acute Pancreatitismentioning

confidence: 99%

“…19,20 RAP has a variable etiology, with the most common causes alcohol abuse and gallstone disease. [18][19][20] Pancreatobiliary malformation, specifically pancreas divisum, has also been associated with the development of RAP. 2,20 A significant proportion of patients with RAP, despite thorough work-up, have no etiology identified, 21 and their disease is thus labeled idiopathic.…”

Section: Recurrent Acute Pancreatitismentioning

confidence: 99%

“…[18][19][20] In natural history studies examining the long-term outcomes of patients after an index episode of AP, the incidence of RAP is estimated to be between 3% and 5% per 100 patient-years, with an overall prevalence of 17% to 20%. 19,20 RAP has a variable etiology, with the most common causes alcohol abuse and gallstone disease. [18][19][20] Pancreatobiliary malformation, specifically pancreas divisum, has also been associated with the development of RAP.…”

Section: Recurrent Acute Pancreatitismentioning

confidence: 99%

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Endoscopic Treatment of Recurrent Acute Pancreatitis and Smoldering Acute Pancreatitis

Das

Yadav

Papachristou

2015

Gastrointestinal Endoscopy Clinics of North America

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“…More than 80% of patients with alcoholic chronic pancreatitis (ACP) are smokers and tobacco has largely been considered to potentiate alcohol toxicity (17,71,87). A retrospective cohort study of ACP showed that cigarette smoking altered the average age at ACP diagnosis; in smokers diagnosis occurred 5 years earlier compared to nonsmokers, and was coupled with increased risk of pancreatic calcification (71).…”

Section: Role Of Tobacco In Development Of Pancreatic Disease: Pancrementioning

confidence: 99%

Smoking induced pancreatitis and pancreatic cancer

Edderkaoui¹

The Pancreapedia: Exocrine Pancreas Knowledge Base

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Abstract:Acute pancreatitis, chronic pancreatitis, and pancreatic cancer are three major pancreatic diseases without any effective treatment. In this character, the latest knowledge regarding the association between these diseases and tobacco smoking is reviewed. Clinical evidence of the association is presented, followed by an overview of scientific evidence, and the potential pathways that mediate smoking-induced pancreatitis and pancreatic cancer.

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

Cited by 41 publications

References 40 publications

Prospective Endoscopic Ultrasound-Based Approach to the Evaluation of Idiopathic Pancreatitis: Causes, Response to Therapy, and Long-term Outcome

Prospective Endoscopic Ultrasound-Based Approach to the Evaluation of Idiopathic Pancreatitis: Causes, Response to Therapy, and Long-term Outcome

Endoscopic Treatment of Recurrent Acute Pancreatitis and Smoldering Acute Pancreatitis

Smoking induced pancreatitis and pancreatic cancer

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