This article is more than 5 years old. Information may no longer be current.
Acute pancreatitis episodes may lead to recurrent pancreatitis; smoking and alcohol abuse a factor
In a retrospective analysis, 17% of patients who experienced an acute pancreatitis for the first time developed recurrent pancreatitis, and nearly 8% of the patients progressed to chronic pancreatitis within the next 5 years.
The biggest risk factor for recurrent pancreatitis was smoking. The highest cumulative risk for chronic pancreatitis was smoking combined with alcohol abuse, according to researchers.
A cohort of 669 patients (median age, 57 years; 55% men) presenting with first-time episodes of acute pancreatitis at 15 hospitals in the Netherlands were included in a cross-sectional, retrospective study with primary endpoints of recurrent pancreatitis and chronic pancreatitis. The patients all had first-time episodes between December 2003 and March 2007 and were followed for a mean time of 57 months after the episode.
Usama Ahmed Ali, BSc, MD, MSc, of the department of surgery, Academic Medical Center, Amsterdam, and colleagues examined data on disease course, outpatient visits and hospital readmissions. Data from imaging, laboratory and histology studies were also collected for the study. Follow-up included patient questionnaires. To obtain results, researchers used regression analysis to evaluate risk factors and Kaplan-Meier analysis to determine cumulative risk.
Among the cohort, 117 (17%) patients developed recurrent pancreatitis and 51 (7.6%) developed chronic pancreatitis within 5 years. Twelve percent of patients with biliary disease developed recurrent pancreatitis and 3% of patients with biliary disease developed chronic pancreatitis. Of all patients with alcoholic etiology, 24% developed recurrent pancreatitis and 16% developed chronic pancreatitis. Over 5 years, the cumulative risk for recurrent pancreatitis was found in 40% of patients who were smokers vs. 13% of those patients who did not smoke. In patients who were smokers and abused alcohol, the cumulative risk for developing chronic pancreatitis was 30%.
“In conclusion, after a first episode of acute pancreatitis, one out of six patients develops [recurrent pancreatitis] and one out of 12 patients progresses to [chronic pancreatitis] within 5 years. Smoking is the predominant risk factor for recurrent disease, while the combination of alcohol and smoking has the highest cumulative risk for chronic disease. Patients should be advised to discontinue alcohol use after a first pancreatitis episode, but should also be made aware of the importance of smoking cessation. The strong and independent association between pancreatic necrosis and both recurrent and chronic pancreatitis provides further support for the ‘necrosis-fibrosis’ sequence,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.