Impact of etiology on course and outcomes of severe acute pancreatitis

Giedrius Barauskas; Povilas Ignatavičius; Astra Vitkauskienė; Juozas Pundzius; Žilvinas Dambrauskas

doi:10.1016/j.medici.2015.04.002

Impact of etiology on course and outcomes of severe acute pancreatitis

Medicina (Kaunas). 2015;51(3):167-172. doi: 10.1016/j.medici.2015.04.002. Epub 2015 Jul 2.

Authors

Giedrius Barauskas¹, Povilas Ignatavičius², Astra Vitkauskienė³, Juozas Pundzius¹, Žilvinas Dambrauskas⁴

Affiliations

¹ Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
² Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Laboratory of Surgical Gastroenterology, Institute for Digestive System Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³ Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁴ Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Laboratory of Surgical Gastroenterology, Institute for Digestive System Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: zilvinas.dambrauskas@gmail.com.

PMID: 28705479
DOI: 10.1016/j.medici.2015.04.002

Abstract

Background and objective: Since the influence of etiological factors on the course and outcomes of acute pancreatitis (AP) is not fully understood yet, the aim of the study was to compare the outcomes of alcoholic and biliary severe acute pancreatitis (SAP).

Materials and methods: We investigated 81 patients with alcoholic and biliary SAP. Demographic data, etiologic factors, severity scores, intra-abdominal pressure, imaging studies, interventions, and treatment outcomes were prospectively entered into specially maintained database and subsequently analyzed.

Results: No statistically significant difference was observed in the prevalence of SAP in biliary and alcoholic AP groups (P=0.429). Although, in the biliary SAP group patients were predominantly elderly women (P=0.003), the total in-hospital stay was longer in alcoholic SAP patients (P=0.021). The abdominal compartment syndrome developed more frequently (P=0.041) and necrosectomy was more frequently performed in alcoholic SAP group (not statistically significant). Although not statistically significant, a lower mortality rate among biliary SAP patients (25.0% vs. 13.5%) was observed.

Conclusions: We defined a trend toward decreased incidence of infected necrosis in larger volume (≥30%) pancreatic necrosis, absence of abdominal compartment syndrome, lower rate of necrosectomies, shorter in-hospital stay, and an insignificantly reduced mortality rate in biliary SAP patients, indicating more favorable course of biliary SAP.

Keywords: Etiology; Outcome; Severe acute pancreatitis.