Pancreatic Function after Acute Biliary Pancreatitis: Does It Change?

Abstract

According to the Cambridge and Marseilles symposia, morphologic and functional recovery from acute biliary pancreatitis (ABP) occurs if the initial cause and complications are eradicated. Nevertheless, in recent years there has been controversy over this topic, and varying results have been reported. These differing results may be due to different diagnostic methods, number of patients studied with regard to etiologic factors, severity of the disease, and differences in the tests used. A total of 63 ABP patients [17 male (27%), 46 female (73%); 45 mild, 18 severe] were prospectively studied. All patients underwent cholecystectomy. No patient in this series underwent necrosectomy or pancreatectomy. During the acute phase the severity of the disease was assessed following the Atlanta criteria, and the occurrence and rate of necrosis were determined by dynamic computed tomography. Exocrine and endocrine pancreatic functions were assessed at 1 month, 6 months, and 1 year after the ABP episode by means of various pancreatic function tests. We evaluated the occurrence of pancreatic failure following ABP and if this deficiency was associated with the severity of the episode. According to the classic symposia criteria, the study showed no deficit in exocrine or endocrine pancreatic function. No statistically significant differences were found when the pancreatic function and severity of the process were assessed.

Severe Acute Pancreatitis: The Life After

“…Previous studies have reported variable figures ranging up MPD main pancreatic duct to 85% following severe acute pancreatitis. [5][6][7][8][12][13][14]17,[25][26][27][28][29] In the present series, insufficiency was 63.6% in the first year and 30% after 3 years of recovery. Improvement in exocrine insufficiency has been noted with passage of time earlier also.…”

“…It is known that the degree of long-term functional abnormalities parallels the severity of the attack and the extent of necrosis. 2 However, Ibars et al 8 and Symersky et al 4 did not find statistically significant differences when the pancreatic function and severity of the pancreatitis were assessed. In the present study, we observed a trend for higher incidence of both exocrine as well as endocrine insufficiency in patients without necrosis compared to those with necrosis (66.6% versus 28.5%).…”

“…[4][5][6][7][8][9][10] There are studies which report that longterm functional and morphological changes do not occur. 7,11 Also, based on etiology, variable long-term functional and morphological changes have been described in alcoholic and biliary pancreatitis 2,[11][12][13][14] and details of morbidity associated with long-term outcome have been reported only in few series.…”

New-Onset Diabetes Mellitus After the First Attack of Acute Pancreatitis: A Systematic Review and Meta-Analysis

“…The search retrieved a total number of 4834 studies of which, 65 relevant papers were included in the assessment. Finally, 12 studies were used in the analysis (Figure 1) (16,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Cohen's kappa coefficient was 0.773 (95% CI: 0.610 -0.936), which indicates a strong consistency.…”

Sa1373 Comparative Evaluation of Structural and Functional Changes in Pancreas After Endoscopic and Surgical Management of Pancreatic Necrosis

“…Initially it was believed that the pancreatic exocrine and endocrine functions return to normal even after an episode of acute severe pancreatitis [1,2]. This was because the majority of the patients who had recovered from an episode of acute necrotizing pancreatitis (ANP) and were asymptomatic were not subjected to investigations for diagnosing pancreatic endocrine or exocrine insufficiency.…”