Gallstone Size and Risk of Pancreatitis

Diehl, Andrew K.; Holleman, Donald R.; Chapman, James B.; Schwesinger, Wayne H.; Kurtin, William E.

doi:10.1001/archinte.1997.00440360088009

Cited by 81 publications

(34 citation statements)

References 22 publications

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“…While Lee (49) and Zhang et al (9) also failed to identify these variables as recurrence risk factors, Monkhouse et al (8) described an association between liver chemistry changes and readmission, but do not specify any reasons regarding the latter. Furthermore, Diehl et al (7) report that gallstone size is a risk factor for AP.…”

Section: Discussionmentioning

confidence: 99%

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

et al. 2016

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Introduction: Acute pancreatitis is often a relapsing condition, particularly when its triggering factor persists. Our goal is to determine the recurrence rate of acute biliary pancreatitis after an initial episode, and the time to relapse, as well as to identify the risk factors for recurrence. Material and method:We included all patients admitted for a first acute gallstone pancreatitis event during four years. Primary endpoints included readmission for recurrence and time to relapse.Results: We included 296 patients admitted on a total of 386 occasions. The incidence of acute biliary pancreatitis in our setting is 17.5/100,000 population/year. In all, 19.6% of pancreatitis were severe (22.6% of severe acute pancreatitis for first episodes versus 3.6% for recurring pancreatitis), with an overall mortality of 4.4%. Overall recurrence rate was 15.5%, with a median time to relapse of 82 days. In total, 14.2% of patients relapsed after an acute pancreatitis event without cholecystectomy or endoscopic retrograde cholangio-pancreatography. Severe acute pancreatitis recur in 7.2% of patients, whereas mild cases do so in 16.3%, this being the only risk factor for recurrence thus far identified.Conclusions: Patients admitted for pancreatitis should undergo cholecystectomy as soon as possible or be guaranteed priority on the waiting list. Otherwise, endoscopic retrograde cholangio-pancreatography with sphincterotomy may be an alternative to surgery for selected patients.

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Section: Discussionmentioning

confidence: 99%

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

et al. 2016

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“…However, the fact that the distal parts of the coledoc cannot be evaluated due to bowel gas superposition constitutes a disadvantage of this method. Stones causing acute pancreatitis are generally smaller than 5mm [19]. Magnetic resonance imaging(MRI) is considerably successful to show biliary tracts and pancreatic ducts that contain stable fluid.…”

Section: Imaging Finding Of Abpmentioning

confidence: 99%

Contemporary Management of Acute Biliary Pancreatitis

Özkan¹

2015

Ann Clin Anal Med

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ÖzetAkut biliary pankreatit, en yaygın akut pankreatit nedenlerindendir. Safra taş-ları, safra çamuru, özellikle nedeni saptanamayanlarda mikrolityazis pankreatit nedeni olabilmektedir. Akut biliyer pankreatit konusu literatürde çok tartışmalı yönleri olan ve sınıflandırma ve klavuzları çok hızlı değişen bir konudur .Akut pankreatit ile ilgili tanımlamaların ve klasifikasyonların yapıldığı Atlanta kriterleri yenilenerek 2013 yılında yayınlanmıştır. Akut biliyer pankreatitte çok kolay tedavi edilebilen hafif şeklinden mortaliteye neden olan komplikasyonlara yo laçan ağır şekline kadar geniş bir spectrum vardır. Bu hastalığın patogenesi tam olarak aydınlatılamamış ve çeşitli teoriler ileri sürülmüştür.Gerek tanı gerekse ağırlık derecesini tahmin etmek için protemiks gibi yeni laboratuar yöntemleri ve skorlama sistemleri önerilmiş ve bunlarla ilgili ça-lışmalar devam etmektedir. ERCP, ES, MRCP, EUS gibi teknolojik gelişmelerle ilişkili yeni tedavi yaklaşımları önerilmektedir. Anahtar KelimelerAkut Bilayer Pankreatit; Tanı; Ağırlığıöngörme; Tedavi AbstractAcute biliary pancreatitis is one of the major causes of acute pancreatitis.Gallstones, biliary sludge and microlithiasis, especially in pancreatitis without detectable reason, can be the cause of acute pancreatitis. Acute biliary pancreatitis has many controversions in the literature, and its classification and guidelines are being updated very frequently. Atlanta classifications which determine the definitions and guidelines about acute pancreatitis were renewed and published in 2013. It has various clinical aspects, ranging from a mild form which is easily treated, to a severe form that causes complications leading to mortality. The pathogenesis of this disease has not been fully elucidated and several theories have been suggested. New scoring systems and laboratory methods such as proteomics have been suggested for both diagnosis and to predict disease severity, and research on these topics is still in progress. Novel therapeutic approaches with technological developments such as ERCP, ES, MRCP, and EUS are also suggested.

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“…The probability of stones causing acute pancreatitis are inversely proportional to its size.It is more probable when stones are less than 5 mm in diameter, because they more easily pass through the cystic duct and cause ampullary obstruction or trauma [20].…”

Section: Etiology Of Acute Pancreatitismentioning

confidence: 99%

Etiology of acute pancreatitis

2014

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AbstractAcute pancreatitis is a common disease with a benign course in the majority of patients, but it is associated with serious morbidity, and mortality close to 20% in up to 20% of cases. The incidence of acute pancreatitis seems to be rising in western countries. About 75% of all cases are caused by gallstones or alcoholism. The relative rate of gallstones versus alcohol as etiology depends on the age and the area of enrolment. A thorough evaluation allows cause identification in another 10% of cases, leaving about 15–20% as idiopathic. The most common causes, and a growing list of less frequent and sometimes very rare and controversial etiologies, are reviewed in this article. A classification on the pathogenic mechanisms of causes of acute pancreatitis based is used in this Review. The approach, or suggested plan of investigations, to determine the etiology of acute pancreatitis, based on the most recently published Guidelines is outlined.

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Gallstone Size and Risk of Pancreatitis

Abstract: Patients with at least 1 gallstone smaller than 5 mm in diameter have a more than 4-fold increased risk of presenting with acute biliary pancreatitis. A policy of watchful waiting in such cases is unwarranted.

Cited by 81 publications

References 22 publications

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

Contemporary Management of Acute Biliary Pancreatitis

Etiology of acute pancreatitis

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