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2015 ; 15
(ä): 87
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Comparison of clinical course and outcome of acute pancreatitis according to the
two main etiologies: alcohol and gallstone
#MMPMID26209440
Cho JH
; Kim TN
; Kim SB
BMC Gastroenterol
2015[Jul]; 15
(ä): 87
PMID26209440
show ga
BACKGROUND: Studies concerning clinical course and outcome of acute pancreatitis
(AP) according to etiologies were rare, especially after year 2000. This study
was designed to investigate the difference between the clinical course of
alcoholic and biliary AP. METHODS: Of the 153 patients diagnosed as AP with a
first attack between January 2011 and January 2013, extensive clinical data of 50
patients with AP caused by alcohol and 76 patients with AP caused by gallstone
were analyzed retrospectively. We compared the severity of AP defined by revised
Atlanta classification in 2012, local complications, severity scores, and
computed tomography severity index (CTSI) between alcoholic and biliary AP. We
also evaluated the length of hospital stay, duration of NPO, and in-hospital
mortality in each group. RESULTS: Hemoglobin, hematocrit, and serum C-reactive
protein level measured after admission for 24 h were significantly higher in the
alcohol group than in the biliary group. Incidence of pseudocyst formation was
significantly higher in the alcohol group than in the biliary group (20.0 % vs.
6.6 %, P?=?0.023). Among prognostic scoring systems, only CTSI showed significant
difference (P?0.001) with a mean score of 3.0?±?0.9 in the alcohol group and
1.7?±?1.2 in the biliary group. Severe AP with organ failure persisting beyond
48 h was observed in 12 patients (24.0 %) in the alcohol group and one patient
(1.3 %) in the biliary group (P?0.001). There were 4 mortalities in the alcohol
group only (P?=?0.012). CONCLUSION: More severe forms of AP and local
complication, such as pseudocyst formation, are associated with alcoholic AP
compared with biliary AP.