A prospective evaluation of pancreatic exocrine function in patients with acute pancreatitis: Correlation with extent of necrosis and pancreatic endocrine insufficiency

Boreham, B.; Ammori, Basil J.

doi:10.1159/000071768

Cited by 100 publications

(85 citation statements)

References 25 publications

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“…A higher HR of development of diabetes was found in the present study for patients admitted with AP (HR, 2.15; 95% CI 1.92-2.41). This finding, which is in agreement with those of other studies, 11,12,14 was confirmed by the observation that the ''diabetes'' diagnosed in these AP patients was not attributable to a transient hyperglycemia but rather to a persistent disease. In patients with severe as compared to mild AP, a slightly but not significantly increased HR of diabetes was observed (2.22; 95% CI, 1.50-3.29).…”

Section: Discussionsupporting

confidence: 93%

“…Whereas a positive relationship between pre-existing AP and development of diabetes has been observed in some studies, 11,12 no association was found in others. 13 Authors of a recently published meta-analysis concluded that patients treated for AP may be at higher risk of developing diabetes after discharge; however, the severity of AP had a minimal effect on the studied outcomes in this analysis.…”

Section: Introductionmentioning

confidence: 90%

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330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

Su¹

2015

Annals of Emergency Medicine

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The proposed bidirectional relationship between acute pancreatitis (AP) and diabetes has never been examined with the same source of data. Furthermore, the effects of disease severity on this relationship have not been fully evaluated. The present study employed the findings from a single database to measure the strength of the association between AP and diabetes.Findings from 1 million National Health Insurance beneficiaries were utilized. Two cohort studies with this database were selected to evaluate the linkage between diabetes and AP. The first cohort analysis addressed the risk of AP among diabetic patients and was comprised of 42,080 diabetic patients and 672,146 unexposed subjects. The second cohort analysis considered the risk of diabetes among patients with AP and enrolled 3187 patients with AP and 709259 unexposed subjects. All adult beneficiaries were followed from January 1, 2005 to December 31, 2012 to identify outcomes of interest. Cox regression models were applied to compare hazards adjusted for potential confounders.For the first cohort, the adjusted hazard ratio (HR) of AP was significantly increased by the presence of diabetes (1.72; 95% confidence interval [CI], 1.52-1.96). In diabetic patients with a history of hyperglycemic crisis episodes (HCEs), the HR was even higher (6.32; 95% CI, 4.54-8.81). For the second cohort, the adjusted HR of diabetes in patients with AP was increased compared to the general population (2.15; 95% CI, 1.92-2.41). For patients with severe AP, the HR was also higher (2.22; 95% CI, 1.50-3.29) but did not differ significantly from that for patients with nonsevere AP.The 2 cohort studies provided evidence for the bidirectional relationship between diabetes and AP. Moreover, diabetic patients with history of HCEs may be associated with higher risk of AP.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 90%

330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

Su¹

2015

Annals of Emergency Medicine

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“…Results showed a marked progression of fi brosis with duration of the disease, which was associated with an increased incidence of calcifi cation and correlated with failure of exocrine and endocrine pancreatic function [12] . In contrast, Boreham and Ammori [29] , in a small number of patients with acute episodes (7 severe, 16 mild) reported no correlation between functional recovery and the cause of the disease. According to their fi ndings, exocrine insuffi ciency was associated with the severity of the attacks as well as with endocrine insufficiency.…”

Section: Progression Of Exocrine and Endocrine Dysfunction After Acutmentioning

confidence: 88%

Endocrine pancreatic insufficiency in chronic pancreatitis

Angelopoulos¹,

Dervenis

Goula

et al. 2005

Pancreatology

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“…So, we can speculate that the basal and stimulated pancreatic enzyme secretion, in particular pancreatic secretory response to CCK, may be woken markedly early, after the onset of AP, as have been shown in experimental studies [13,14] . Evidence allows us to conclude that in human pancreatitis the injured pancreas may be less responsive to stimulation by food than previously considered [15,16] .…”

Section: Refeeding In Apmentioning

confidence: 87%

Oral refeeding in mild acute pancreatitis: An old challenge

Chebli

Gaburri²,

Chebli

2011

WJGP

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Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP) therapy, the right time and type of diet to be offered to patients recovering from an acute attack are a great challenge to clinicians who treat this condition. Fortunately, the last decade was noted for several trials looking for the best answer to the question: "when and how to start oral refeeding in AP?" It is well known that 80% of patients present with mild disease characterized by usually uncomplicated clinical course are managed with pancreatic rest through nil per oral; while the use of specific nutritional intervention is an exception. Therefore, mild AP has been the most investigated form of AP and researchers have tried different kind of meals to offer calories and reduce costs by shortening hospitalization time. Usually in mild AP, the oral refeeding is introduced between the first 3 d and 7 d after hospitalization but, the type of diet and patients' tolerance have been scrutinized in detail with mixed results. Although 20% to 25% have pain recurrence requiring nutritional support and greater time of hospitalization, most patients seem to tolerate oral refeeding well. We propose analyzing the most recent investigations of this matter and their conclusions to develop a better understanding of the management of AP.

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A prospective evaluation of pancreatic exocrine function in patients with acute pancreatitis: Correlation with extent of necrosis and pancreatic endocrine insufficiency

Cited by 100 publications

References 25 publications

330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

330 Bidirectional Relationship Between Diabetes and Acute Pancreatitis: A Population-Based Cohort Study in Taiwan

Endocrine pancreatic insufficiency in chronic pancreatitis

Oral refeeding in mild acute pancreatitis: An old challenge

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