Recurrent acute pancreatitis:etiology and selection of treatment regimen

Objective To investigate the etiology of recurrent acute pancreatitis ( RAP) and selection of treatment regimen. Methods A retrospective analysis was performed for the clinical data of 284 patients with acute pancreatitis ( AP) who were admitted to The Second People's Hospital of Neijiang from January 2012 to December 2015, and among these patients, 232 had incipient AP ( incipient group) and 52 had RAP ( recurrent group) . The two groups were analyzed in terms of general status, etiology, number of times of recurrence, recurrence interval, treatment regimen, and prognosis. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the incipient group, the recurrent group had a significantly higher proportion of patients with biliary factors ( 66. 8% vs 35. 8%, χ2= 7. 109, P = 0. 008) or hyperlipidemia ( 17. 3% vs16. 0%, χ2= 5. 818, P = 0. 007) , as well as a significantly lower proportion of patients with diet factors ( 7. 7% vs 21. 1%, χ2= 5. 046, P = 0. 025) . Among the 52 patients in the recurrent group, 33 ( 63. 46%) had one time of recurrence, 14 ( 26. 92%) had two times of recurrence, and 5 ( 9. 62%) had three or more times of recurrence; as for recurrence interval, 12 ( 23. 08%) had a recurrence interval of less than 6 months, 23 ( 44. 23%) had a recurrence interval of 6-12 months, and 17 ( 32. 69%) had a recurrence interval of more than 12 months; as for the selection of treatment regimen, 23 underwent surgical treatment, 23 underwent conservative treatment, and 6 underwent endoscopic therapy. These patients were followed up for 6-24 months, and no patient died or experienced recurrence. Conclusion RAP has a complex etiology, and biliary factors and hyperlipidemia are closely associated with the recurrence of AP. Identification of etiology and active etiological treatment can effectively reduce the recurrence rate of AP.