Clinical Gastroenterology and Hepatology
Long-Term Prognosis of Acute Pancreatitis in Japan
Section snippets
Patients and Methods
In Japan under the financial support of the government, nationwide survey of AP has been done periodically from 1987, and a database of 2533 cases registered in 1987 has been available. From this registry a follow-up study was performed in 2000, and valid replies were available from 714 cases. At the time of admission, all the patients were classified by severity into moderate and severe according to the criteria for clinical diagnosis and grading severity (1990) formulated by the Research
Recurrence of Acute Pancreatitis
During the follow-up period, recurrence of AP was observed in 145 cases (20.3%). The recurrence rate was 23.1% in moderate pancreatitis and 16.7% in SAP. The recurrence rates in alcoholic pancreatitis, biliary pancreatitis, idiopathic pancreatitis, and pancreatitis of other etiologies were 32.4%, 7.4%, 17.9%, and 10.7%, respectively. Recurrence rate was significantly higher in alcoholic pancreatitis compared with the other origins (P < .01). The recurrence rate was not influenced by either the
Discussion
Previous reports on overall recurrence rates of AP range from 21%–27%.5, 6 The recurrence rate in the present analysis was 20.3%, which was similar to the previous reports. With respect to the etiology of AP, Pelli et al3 reported that the recurrence of AP was noted in 46% of 568 patients with alcoholic AP and that 80% of recurrent AP occurred within 4 years after the first episode. In the present study, the recurrence rate in alcoholic AP was significantly higher (32.4%) than other etiologies.
Summary
This prospective longitudinal study has examined the natural history of AP in a Japanese population that has been followed for more than 20 years. The key findings of this study are that the extent of necrosis at the time of initial presentation affects the risk of subsequently developing CP. In patients with alcoholic pancreatitis, continued drinking had a significant impact on the risk for developing CP and DM. Finally, a history of AP did not appear to affect the risk for developing
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Conflicts of interest The author discloses no conflicts.