Usefulness of scheduled follow-up CT in discharged patients with acute pancreatitis

Cho, Jeong Hyeon; Choi, June Seek; Hwang, Eui Tae; Park, Ji Young; Jeon, Tae Joo; Kim, Hee Man; Cho, Jae Hee

doi:10.1016/j.pan.2015.09.004

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…Even if applied, diffuse pancreatic inflammation can mask a localized mass in the acute setting (21,22). Cho et al argued that AP patients who had no clear etiology should routinely receive CT within three months after discharge in order to reveal underlying tumor (23). In our study, the overall sensitivity of CT in detecting pancreatic tumor was 85%, which was significantly higher than that of ultrasonography (30%).…”

Section: Discussionmentioning

confidence: 54%

“…Our data supported conclusions by other authors that those idiopathic AP patients should be closely followed after discharge to avoid missed diagnosis of pancreatic tumors. If possible, such investigations should be performed after an interval of 3 to 4 weeks or scheduled follow-up at least within three months after discharge to allow for resolution of inflammatory changes secondary to the pancreatitis episode (23). Furthermore, we noted that in the present study, about one third of patients with PC remained undetectable in three months after discharge.…”

Section: Discussionmentioning

confidence: 69%

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Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

Xiong¹,

Zhao²,

Han³

et al. 2021

Ann Transl Med

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Background: What features should alert clinicians to suspect underlying tumors in patients with acute pancreatitis (AP) was largely unknown. This study aimed to assess the clinical characteristics and outcome in patients with tumor-associated AP.Methods: Patients who presented with AP and were diagnosed with tumor after admission were included according to the inclusion and exclusion criteria and followed up by hospital notes, telephone, WeChat and/ or e-mail. The clinical characteristics and outcome were analyzed with multivariable logistic regression and were compared with AP patients without tumor.Results: Out of a cohort of 1,792 AP patients we identified 103 who had a neoplastic etiology. The 103 patients had a median age of 57 (range, 13-81) and 65 were males. AP was mild in 92 patients, moderately severe in 7 and severe in 4. The three most common tumors included pancreatic cancer (PC) (40), periampullary carcinoma (PAC) (25), and neoplastic pancreatic cysts (NPC) (22). The following ranked features were predictive of a tumor etiology: dilation of main pancreatic duct (MPD) (

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 69%

Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

Xiong¹,

Zhao²,

Han³

et al. 2021

Ann Transl Med

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“…Consequently, many cases may be inaccurately diagnosed as AP[ 32 ]. Based on this, Cho et al[ 33 ] suggested that occurrence of AP may be an indicator for PC, affirming the need for early examinations, after an interval of 3 to 4 wk, to allow for resolution of inflammatory changes secondary to the pancreatitis episode, especially in high-risk patients. Consequently, a spuriously strong overall association has been reported in patients misdiagnosed with AP, when in fact they had PC.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis reveals an association between acute pancreatitis and the risk of pancreatic cancer

Liu¹,

Wang²,

Yu³

2020

WJCC

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BACKGROUND Chronic pancreatitis is associated with pancreatic cancer (PC), although the relationship between acute pancreatitis (AP) and the risk of PC remains unclear due to inconsistent and contradictory results. AIM To conduct a meta-analysis of retrospective and prospective studies to explore the association between AP and PC risk. METHODS We first searched original articles on the association of AP with PC using PubMed, Web of Science, Cochrane, and EMBASE databases. Then we calculated the combined overall effect estimates (EEs) between AP and PC risk at a 95% confidence interval (CI) deploying a random-effects model, and assessed heterogeneity using the I 2 test. The combined relative risk with 95%CI was performed to examine the relationship between AP and PC. Publication bias and subgroup analyses were also conducted. Furthermore, we performed sensitivity analysis to explain this heterogeneity. RESULTS Eleven studies were eligible for inclusion standards in this meta-analysis, resulting in pooled EEs of 2.07 (95%CI: 1.36-2.78) for AP and PC risk. Additionally, five prospective cohort studies reported 103961 patients in the AP group, relative to 1442158 subjects in the control group, with a pooled relative risk of 7.81 (95%CI: 5.00-12.19). We also performed subgroup analyses using different follow-up times and type of research methods (case-control or cohort). Results from analyses of different follow-up times revealed the following pooled effect values: 1-year lag period (EEs = 23.47, 95%CI: 3.26-43.68), 2-year lag period (EEs = 9.82, 95%CI: 3.01-16.64), 5-year lag period (EEs = 2.47, 95%CI: 1.93-3.02), 10-year lag period (EEs = 1.69, 95%CI: 1.26-2.11), and > 10-year lag period (EEs = 1.17, 95%CI: 0.78-1.57). With regards to the methods, the case-control studies recorded EEs = 3.03 (95%CI: -1.02 to 7.08), whereas cohort studies had EEs = 2.09 (95%CI: 1.22-2.97) pooled effect values. CONCLUSION Overall, our findings indicated an association between AP and PC risk. Based on subgroup analyses, AP is unlikely to be a causal factor for PC.

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“…Die Inzidenz interventionspflichtiger peripankreatischer Flüssigkeitsverhalte nach erster Episode einer akuten Pankreatitis steigt mit dem Schweregrad. Diese Patienten sind häufig symptomatisch 291 309 .…”

Section: Verlaufskontrolle Nach Akuter Pankreatitisunclassified

S3-Leitlinie Pankreatitis – Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – September 2021 – AWMF Registernummer 021-003

et al. 2022

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Kapitel: Definition und Ätiologie der akuten Pankreatitis 427 2. Schweregradeinschätzung einer akuten Pankreatitis 431 3. Bildgebung bei akuter Pankreatitis 435 4. Volumen-und Schmerztherapie, Intensivmedizinische Therapie bei akuter Pankreatitis 438 5. Antibiotika, Probiotika und Ernährung bei akuter Pankreatitis (Prävention und Therapie infektiöser Komplikationen) 442 6. Akute biliäre Pankreatitis und Therapie biliärer Komplikationen 445 7. Indikation, Zeitpunkt und Therapieverfahren bei infizierter Nekrose 448 8. Verlaufskontrolle nach akuter Pankreatitis 452 9. Definition, Epidemiologie und Ätiologie der chronischen Pankreatitis 456 9.1. Definition 456 10. Diagnostik (Funktionstests, Bildgebung, Klassifikation) bei chronischer Pankreatitis 459 10.3. Funktionstests 459 10.4. Bildgebung 461 10.5. Klassifikation 462 11. Medikamentöse Therapie der chronischen Pankreatitis 464 11.1. Akuter Schub 464 11.2. Schmerztherapie 464 11.3. Enzymsubstitution bei chronischer Pankreatitis 467 11.4. Ernährung 470 Inhaltsverzeichnis Seite 12. Endoskopische und interventionelle Therapie 471 12.1. Indikationsstellung 471 12.2. Therapie von Pseudozysten 473 12.3. Therapie von Pseudoaneurysmen 476 12.4. Therapie von Pankreasgangveränderungen und Pankreasgangsteinen bei chronischer Pankreatitis 477 12.5. Endoskopische Therapie von Gallengangsstenosen bei chronischer Pankreatitis 479 13. Indikationsstellung und chirurgische Therapie bei chronischer Pankreatitis 480 14. Überwachung und Verlaufskontrolle 484 15. Diagnostik und Therapie der chronischen Pankreatitis im Kindesalter 486 15.2. Klinisches Bild der Pankreatitis bei Kindern und Jugendlichen 486 15.3. Ätiologie und Häufigkeitsverteilung der Pankreatitis im Kindes-und Jugendalter 486 15.4. Komplikationen der Pankreatitis bei Kindern und Jugendlichen 487 15.5. Labordiagnostik bei V. a. Pankreatitis im Kindesund Jugendalter 487 15.6. Bildgebende Diagnostik bei Pankreatitis im Kindes-und Jugendalter 488 15.7. Genetische Diagnostik bei Pankreatitis im Kindes-und Jugendalter 489 15.8. Spezifische Diagnostik zum Ausschluss einer zystischen Fibrose bei Kindern und Jugendlichen mit chronischer Pankreatitis 489 15.9. Supportive Therapiemaßnahmen bei Kindern und Jugendlichen im akuten Schub einer Pankreatitis 490 15.10. Endoskopisch-interventionelle Therapie bei Kindern und Jugendlichen mit Pankreatitis 490 15.11. Operative Therapie bei Kindern und Jugendlichen mit Pankreatitis 490 15.12. Schmerztherapie der chronischen Pankreatitis bei Kindern und Jugendlichen 490 15.13. Ernährung bei Kindern im akuten Schub einer Pankreatitis 491

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Usefulness of scheduled follow-up CT in discharged patients with acute pancreatitis

Cited by 10 publications

References 24 publications

Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

Clinical characteristics and outcome of tumor-associated acute pancreatitis: a single-center cohort study

Meta-analysis reveals an association between acute pancreatitis and the risk of pancreatic cancer

S3-Leitlinie Pankreatitis – Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – September 2021 – AWMF Registernummer 021-003

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