Severe Acute Pancreatitis: The Life After
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- 作者：Rajesh Gupta (1)
Jai Dev Wig (1)
Deepak Kumar Bhasin (2)
Paramjit Singh (3)
Sudha Suri (3)
Mandeep Kang (3)
Surinder Singh Rana (2)
Satyawati Rana (2) - 关键词：Severe acute pancreatitis ; Exocrine insufficiency ; Endocrine insufficiency ; Urinary d ; xylose excretion ; Pancreatic morphology
- 刊名：Journal of Gastrointestinal Surgery
- 出版年：2009
- 出版时间：July 2009
- 年：2009
- 卷：13
- 期：7
- 页码：1328-1336
- 全文大小：311KB
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35. Pelli H, Sand J, Laippala P et al. Long term follow-up after the first episode of acute alcoholic pancreatitis: time course and risk factors for recurrence. Scand J Gastroenterol. 2000;5:552-. - 作者单位：Rajesh Gupta (1)
Jai Dev Wig (1)
Deepak Kumar Bhasin (2)
Paramjit Singh (3)
Sudha Suri (3)
Mandeep Kang (3)
Surinder Singh Rana (2)
Satyawati Rana (2)
1. Surgical Gastroenterology Division, Department of General Surgery, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India, 160012
2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
文摘
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--.04 and 0.28, respectively) and infected compared to sterile pancreatitis (45% vs. 25%, p--.55 and 50% vs. 12%, p--.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.