Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology
Aim To define a therapeutic program for mild-moderate acute pancreatitis (AP), often recurrent, which at the end of the diagnostic process remains of undefined etiology. Material and Methods In the period 2011-2012, we observed 64 cases of AP: 52 mild-moderate, 12 severe; biliary 39, biliary in alco...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2014-07-01
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| Series: | Clinical Medicine Insights: Gastroenterology |
| Online Access: | https://doi.org/10.4137/CGast.S13531 |
| _version_ | 1828412536185159680 |
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| author | Vincenzo Neri Francesco Lapolla Alessandra Di Lascia Libero Luca Giambavicchio |
| author_facet | Vincenzo Neri Francesco Lapolla Alessandra Di Lascia Libero Luca Giambavicchio |
| author_sort | Vincenzo Neri |
| collection | DOAJ |
| description | Aim To define a therapeutic program for mild-moderate acute pancreatitis (AP), often recurrent, which at the end of the diagnostic process remains of undefined etiology. Material and Methods In the period 2011-2012, we observed 64 cases of AP: 52 mild-moderate, 12 severe; biliary 39, biliary in alcoholic chronic pancreatitis 5, unexplained recurrent 20. The clinical and instrumental evaluation of the 20 cases of unexplained AP showed 6 patients with biliary sludge, 4 microlithiasis, 4 sphincter of Oddi dysfunction, and 6 cases that remained undefined. Results Among 20 patients with recurrent, unexplained AP at initial etiological assessment, we performed 10 video laparo cholecystectomies (VLCs), 2 open cholecystectomies and 4 endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomies (ERCP/ES) in patients who had undergone previous cholecystectomy; 4 patients refused surgery. Among these 20 patients, 6 had AP that remained unexplained after second-level imaging investigations. For these patients, 4 VLCs and 2 ERCP/ES were performed. Follow-up after six months was negative for further recurrence. Conclusion The recurrence of unexplained acute pancreatitis could be treated with empirical cholecystectomy and/or ERCP/ES in cases of previous cholecystectomy. |
| first_indexed | 2024-12-10T12:50:59Z |
| format | Article |
| id | doaj.art-28c0951f3a6f493a9fafd0f26e8ab272 |
| institution | Directory Open Access Journal |
| issn | 1179-5522 |
| language | English |
| last_indexed | 2024-12-10T12:50:59Z |
| publishDate | 2014-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Gastroenterology |
| spelling | doaj.art-28c0951f3a6f493a9fafd0f26e8ab2722022-12-22T01:48:15ZengSAGE PublishingClinical Medicine Insights: Gastroenterology1179-55222014-07-01710.4137/CGast.S13531Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown EtiologyVincenzo Neri0Francesco Lapolla1Alessandra Di Lascia2Libero Luca Giambavicchio3General Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.General Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.General Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.General Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.Aim To define a therapeutic program for mild-moderate acute pancreatitis (AP), often recurrent, which at the end of the diagnostic process remains of undefined etiology. Material and Methods In the period 2011-2012, we observed 64 cases of AP: 52 mild-moderate, 12 severe; biliary 39, biliary in alcoholic chronic pancreatitis 5, unexplained recurrent 20. The clinical and instrumental evaluation of the 20 cases of unexplained AP showed 6 patients with biliary sludge, 4 microlithiasis, 4 sphincter of Oddi dysfunction, and 6 cases that remained undefined. Results Among 20 patients with recurrent, unexplained AP at initial etiological assessment, we performed 10 video laparo cholecystectomies (VLCs), 2 open cholecystectomies and 4 endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomies (ERCP/ES) in patients who had undergone previous cholecystectomy; 4 patients refused surgery. Among these 20 patients, 6 had AP that remained unexplained after second-level imaging investigations. For these patients, 4 VLCs and 2 ERCP/ES were performed. Follow-up after six months was negative for further recurrence. Conclusion The recurrence of unexplained acute pancreatitis could be treated with empirical cholecystectomy and/or ERCP/ES in cases of previous cholecystectomy.https://doi.org/10.4137/CGast.S13531 |
| spellingShingle | Vincenzo Neri Francesco Lapolla Alessandra Di Lascia Libero Luca Giambavicchio Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology Clinical Medicine Insights: Gastroenterology |
| title | Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology |
| title_full | Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology |
| title_fullStr | Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology |
| title_full_unstemmed | Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology |
| title_short | Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology |
| title_sort | defining a therapeutic program for recurrent acute pancreatitis patients with unknown etiology |
| url | https://doi.org/10.4137/CGast.S13531 |
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