Acute Recurrent Pancreatitis; Relative Risk Factors, Etiology ,Diagnosis Procedure And Treatment In the Pancreatic disease Institute of Wuhan Union Hospital Of China

Abstract

This study describes the relative risk factors, etiology and treatment option of recurrent acute pancreatitis. The data of 71 patients with acute recurrent pancreatitis were retrospectively studied from January 2010 to December 2014. Of 71 patients, 41 were male and 30 were female with a sex ratio of 1.4:1 with a mean age of 49 years. Their age ranged from 14 to 85 years. After reviewing the clinical data, the risk factors were analyzed using univariate and multivariate analysis. The etiology was investigated in each case using specialized laboratory analysis, ERCP, EUS and MRCP. Their pain was labeled severe, moderate and mild by using the Analgesic Ladder by World Health Organization. Subsequent to the investigation reports, therapeutic ERCP and endoscopic sphincterotomy were performed. Of the 71 patients, 52 cases were biliary pancreatitis, 13 were idiopathic pancreatitis, 3 were alcohol induced pancreatitis and 3 were hyperlipidemia pancreatitis. The univariate analysis showed easy recurrence with obstructive jaundice, hepatic function injury and local complication of pancreas (P=0.016< 0.05 P= 0.003<0.05 and P= 0.024< 0.05 correspondingly). Multivariate analysis showed no single factor related to recurrence. Upon definition of etiology, there were 33 cases of common bile duct stones, 14 cases of pancreatic duct stones, 5 cases of gallbladder stones, 3 cases of pancreas divisum, 2 cases of ampullary tumor, 4 cases of sphincter of Oddi dysfunction, 6 cases of chronic pancreatitis, 1 cases of  post liver transplant complication and 3 cases of duodenal diverticulum. The 71 patients performed ERCP followed by either endoscopic sphincterotomy in 69 cases or endoscopic resection in 2 cases. The procedure was curative and successfully performed. A complication rate of 2.8% with no mortality was observed. Post-therapy, a decline in pain intensity was observed in 56 cases of the patients. ERCP and endoscopic sphincterotomy has a curative effect in diverse etiology of acute recurrent pancreatitis.