Clinical and therapeutic correlations in patients with slight acute pancreatitis

Abstract

BackgroundAcute pancreatitis is an inflammatory disease of the pancreas due to enzymatic autodigestion which can cause necrosis or multiple organ failure; its pathophysiology is not fully known yet.AimTo evaluate the correlation between clinical and therapeutic data in patients with mild acute pancreatitis.MethodsA retrospective study in 55 medical records of patients admitted with acute mild pancreatitis was realized to analyze the association between age, leukocytosis, serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose, antibiotics, time admission and Ranson´s scores.ResultsThere was a positive association between less intensive care (strict hydration, analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy), early return to diet after 48 hours and laboratory control of the serum amylase and lipase (high in the first week and decreasing after 10 days, without any prognostic value).ConclusionsChanges in the management of patients with mild acute pancreatitis, such as enteral nutrition, rational use of lower spectrum antibiotics and intensive care, have contributed significantly to the reduction of hospitalization time and mortality.

Serial lipase for pancreatitis: not enough evidence

“…Findings consistent with other studies, which indicate no prognostic/predictive value for lipase in acute pancreatitis …”

“…The conclusion of the authors remains consistent with larger clinical studies indicating no prognostic value for lipase in patients with acute pancreatitis …”

“…Our review reveals a paucity of data on which to advise the clinical validity of serial lipase measurement in acute pancreatitis . Seven observational studies were identified in our review, with five retrospective studies concluding that serial lipase measurement was a poor prognostic marker . One prospective study by Ostrovskii et al .…”

“…The poor utility of lipase in prognostication is expected, as biochemically, the serum concentration of the enzyme lags several hours behind clinical events, and then remains circulating for up to 10 days . With this delayed clearance, the sensitivity of this assay is reduced, and likely precludes its ability to indicate a worsening condition of the patient.…”

Clinical and epidemiological aspects of acute pancreatitis - 10 years of single-center experience

“…One of the criteria to correctly diagnose AP is an increase of pancreatic enzymes (amylase, lipase) activity in the blood [1][2]. While it is widely thought that the direct levels of enzyme activity in the blood do not have a prognostic value, we have noted that amylase levels do correlate with a clinical type of AP [30][31][32][33][34]. In the first days of illness, the amylase activity levels are significantly higher in severe AP than in mild or moderate AP.…”