Clinical and prognostic features of acute alcoholic pancreatitis

Jiang Xin; Xu Huan; Yan YongFeng; Zhong Rui; Luo XuJuan; Shi XiaoMin; Wang Min; Peng Yan; Tang XiaoWei

doi:10.3969/j.issn.1001-5256.2019.11.027

Volume 35 Issue 11

Nov. 2019

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Article Navigation > Journal of Clinical Hepatology > 2019 > 35(11): 2528-2532

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Clinical and prognostic features of acute alcoholic pancreatitis

DOI: 10.3969/j.issn.1001-5256.2019.11.027

Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University

Research funding:

Received Date: 2019-07-15
Published Date: 2019-11-20

Abstract

Abstract

Objective To investigate the clinical and prognostic features of acute alcoholic pancreatitis. Methods A total of 467 patients with incipient acute pancreatitis( AP) who were admitted to The Affiliated Hospital of Southwest Medical University from July 2013 to July2018 were enrolled as subjects,and among these patients,182 with alcoholic AP were enrolled as alcoholic group and 285 with biliary AP were enrolled as biliary group. The two groups were compared in terms of the clinical features such as age,sex,laboratory markers,disease grade,complications,and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups,and the Mann-Whitney U test was used for comparison of ranked data between two groups. Results Compared with the biliary group,the alcoholic group had significantly higher constituent ratio of male patients( 74. 2% vs 48. 1%,χ2= 31. 124,P < 0. 001) and proportion of patients with fatty liver disease( 34. 1% vs 24. 9%,χ2= 4. 569,P = 0. 033). The biliary group had a significantly higher proportion of patients with hypertension than the alcoholic group( 23. 5% vs 15. 4%,χ2= 4. 524,P = 0. 033). Compared with the biliary group,the alcoholic group had significantly higher levels of creatinine and triglyceride( Z =-4. 828,t = 7. 916,both P < 0. 001),proportion of patients with severe AP( 34. 6% vs 15. 1%,Z =-4. 787,P < 0. 001),and CTSI score( 4. 6 ± 1. 7 vs 4. 2 ± 1. 5,t = 2. 672,P = 0. 008). Compared with the biliary group,the alcoholic group had significantly higher probabilities of acute peripancreatic fluid accumulation( 61. 0% vs 49. 8%,χ2=5. 045,P < 0. 05),pancreatic pseudocyst( 11. 5% vs 4. 2%,χ2= 8. 881,P < 0. 05),infectious pancreatic necrosis( 37. 9% vs 19. 6%,χ2= 18. 899,P < 0. 05),and renal failure( 19. 2% vs 8. 4%,χ2= 11. 758,P < 0. 05). Compared with the biliary group,the alcoholic group had significantly longer time to intestinal function recovery,time to relief of abdominal pain,and length of hospital stay( t =-4. 078,-3. 357,and-2. 527,all P < 0. 05). There was a significant difference in mortality rate between the alcoholic group and the biliary group( 7. 1% vs 3. 2%,χ2= 3. 929,P = 0. 047). Conclusion Compared with the biliary group,the alcoholic group has a higher risk of complications,worse clinical manifestations,and a higher mortality rate. Therefore,alcohol abstinence education should be performed for this population,especially men,in order to reduce adverse outcomes.
- pancreatitis,alcoholic,
- cholelithiasis,
- signs and symptoms,
- prognosis

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References(34)

References

[1] WANG CY,LI F,ZHAO YP,et al. Treatment of acute pancreatitis(2014)[J]. J Clin Hepatol,2015,31(1):17-20.(in Chinese)王春友，李非，赵玉沛，等．急性胰腺炎诊治指南(2014)[J]．临床肝胆病杂志，2015,31(1):17-20.

[2] CROCKETT SD,WANI S,GARDNER TB,et al. American Gastroenterological Association Institute Guideline on initial management of acute pancreatitis[J]. Gastroenterology,2018,154(4):1096-1101.

[3] GULLO L,MIGLIORI M,OLAH A,et al. Acute pancreatitis in five European countries:Etiology and mortality[J]. Pancreas,2002,24(3):223-227.

[4] HUANG LB,TANG CW,XIE YM,et al. Risk factors of 3073cases of acute pancreatitis in Chengdu[J]. J Sichuan Univ:Med Sci Ed,2005,36(1):138-139.(in Chinese)黄丽彬，唐承薇，谢咏梅，等．成都地区3073例急性胰腺炎致病危险因素分析[J]．四川大学学报:医学版，2005,36(1):138-139.

[5] FENG ZD,LIU ZJ. Clinical analysis of early and delayed laparoscopic cholecystectomy for mild acute biliary pancreatitis[J]. Chin J Med Offic,2018,46(2):213-215.(in Chinese)冯章东，刘佐军．早期与延期腹腔镜胆囊切除术治疗轻型急性胆源性胰腺炎临床疗效分析[J]．临床军医杂志，2018,46(2):213-215.

[6] WU HH. Clinical characteristics and prognosis of acute biliary pancreatitis and acute alcoholic pancreatitis[J]. J Qiqihar Med Coll,2015,36(12):1794-1795.(in Chinese)吴航海．急性胆源性胰腺炎与急性酒精性胰腺炎的临床特点及预后分析[J]．齐齐哈尔医学院学报，2015,36(12):1794-1795.

[7] YU XE,DENG YH,HUANG PN,et al. Clinical study on alcoholic effect in the severity of acute pancreatitis[J]. Chin J Gastroenterol Hepatol,2015,24(7):875-878.(in Chinese)余贤恩，邓有辉，黄培宁，等．酒精在急性胰腺炎重症化中作用的临床研究[J]．胃肠病学和肝病学杂志，2015,24(7):875-878.

[8] LI Q,WU PF,XU ZK,et al. Clinical and prognostic analysis of85 cases of alcoholic acute pancreatitis[J]. Jiangsu Med J,2013,39(24):3025-3026.(in Chinese)李强，吴鹏飞，徐泽宽，等．85例酒精性急性胰腺炎的临床与预后分析[J]．江苏医药，2013,39(24):3025-3026.

[9] ZHAO B. Clinical characteristics and prognosis of acute biliary pancreatitis and acute alcoholic pancreatitis[J]. Mod Diagn Treat,2013,24(13):3058-3059.(in Chinese)赵波．急性胆源性胰腺炎与急性酒精性胰腺炎的临床特点及预后分析[J]．现代诊断与治疗，2013,24(13):3058-3059.

[10] BANKS PA,BOLLEN TL,DERVENIS C,et al. Classification of acute pancreatitis-2012:Revision of the Atlanta classification and definitions by international consensus[J]. Gut,2013,62(1):102-111.

[11] TENNER S,BAILLIE J,DEWITT J,et al. American College of Gastroenterology Guidelines:Management of acute pancreatitis[J]. Am J Gastroenterol,2013,108(9):1400-1415,1416.

[12] ZHANG N,ZHANG HY,GUO XH,et al. Changes of etiology in acute pancreatitis in recent 10 years in China:Meta-analysis[J/CD]. Chin J Digest Med Imageol:Electronic Edition,2016,6(2):71-75.(in Chinese)张娜，张海燕，郭晓红，等．中国近十年急性胰腺炎病因变化特点的Meta分析[J/CD]．中华消化病与影像杂志:电子版，2016,6(2):71-75.

[13] CHEN YT. Investigation of etiology and clinical characteristics of acute pancreatitis in four hospitals in Xi'an[D]. Yinchuan:Ningxia Medical University,2016.(in Chinese)陈依婷．西安市四家医院的急性胰腺炎病因调查及临床特点分析[D]．银川:宁夏医科大学，2016.

[14] RUAN JG,SUN JL,ZANG Y. Etiology and clinical characteristics of acute pancreatitis[J]. J Ningxia Med Univ,2016,38(7):791-794.(in Chinese)阮继刚，孙金玲，臧媛．急性胰腺炎的病因及临床特征分析[J]．宁夏医科大学学报，2016,38(7):791-794.

[15] LI ZF,ZHAO Q,WANG B. Analysis of the etiology of acute pancreatitis in Southwest Shandong Province in the past 20years[J]. Chin J Pancreatol,2018,18(6):399-401.(in Chinese)李振方，赵琦，王兵．山东鲁西南地区近20年急性胰腺炎患者病因变化分析[J]．中华胰腺病杂志，2018,18(6):399-401.

[16] KONG LX,ZHANG JW. Severity and local complications of acute pancreatitis based on etiology[J]. Lab Med Clin,2016,13(9):1209-1210,1213.(in Chinese)孔琳熙，张俊文．急性胰腺炎病因与局部并发症及严重程度的相关性分析[J]．检验医学与临床，2016,13(9):1209-1210,1213.

[17] STERNBY H,BOLADO F,CANAVAL-ZULETA HJ,et al. Determinants of severity in acute pancreatitis:A nation-wide multicenter prospective cohort study[J]. Ann Surg,2019,270(2):348-355.

[18] NESVADERANI M,ESLICK GD,VAGG D,et al. Epidemiology,aetiology and outcomes of acute pancreatitis:A retrospective cohort study[J]. Int J Surg,2015,23(Pt A):68-74.

[19] GAPP J,HALL AG,WALTERS RW,et al. Trends and outcomes of hospitalizations related to acute pancreatitis:Epidemiology from 2001 to 2014 in the United States[J]. Pancreas,2019,48(4):548-554.

[20] SAMARASEKERA E,MAHAMMED S,CARLISLE S,et al.Pancreatitis:Summary of NICE guidance[J]. BMJ,2018,362:k3443.

[21] YADAV D,PAPACHRISTOU GI,WHITCOMB DC. Alcoho-associated pancreatitis[J]. Gastroenterol Clin North Am,2007,36(2):219-238.

[22] SATOH K,SHIMOSEGAWA T,MASAMUNE A,et al. Nationwide epidemicological survey of acute pancreatitis in Japan[J]. Pancreas,2011,40(4):503-507.

[23] KRISTIANSEN L,GRNBAEK M,BECKER U,et al. Risk of pancreatitis according to alcohol drinking habits:A population-based cohort study[J]. Am J Epidemiol,2008,168(8):932-937.

[24] ZHU Y,PAN X,ZENG H,et al. A study on the etiology,severity,and mortality of 3260 patients with acute pancreatitis according to the revised atlanta classification in Jiangxi,China over an 8-year period[J]. Pancreas,2017,46(4):504-509.

[25] KIM KO,KIM TN. Acute pancreatic pseudocyst:Incidence,risk factors,and clinical outcomes[J]. Pancreas,2012,41(4):577-581.

[26] FAN LY,JIANG YG,KONG XJ,et al. Risk factors analysis for the formation of pancreatic pseudocysts in acute pancreatitis[J]. Chin J Pancreatol,2018,18(1):20-24.(in Chinese)范丽玉，姜英俊，孔心涓，等．急性胰腺炎并发胰腺假性囊肿形成的危险因素分析[J]．中华胰腺病杂志，2018,18(1):20-24.

[27] CUI ML,KIM KH,KIM HG,et al. Incidence,risk factors and clinical course of pancreatic fluid collections in acute pancreatitis[J]. Dig Dis Sci,2014,59(5):1055-1056.

[28] POORNACHANDRA KS,BHASIN DK,NAGI B,et al. Clinical,biochemical,and radiologic parameters at admission predicting formation of a pseudocyst in acute pancreatitis[J]. J Clin Gastroenterol,2011,45(2):159-163.

[29] YU XE. Analysis of causes and prognosis of 113 patients with severe acute pancreatitis[J]. Chin J Primary Med Pharm,2012,19(4):526-528.(in Chinese)余贤恩．重症急性胰腺炎113例病因及预后分析[J]．中国基层医药，2012,19(4):526-528.

[30] RAZVODOVSKY YE. Alcohol consumption and pancreatitis mortality in Russian[J]. JOP,2014,15(4):365-370.

[31] XU C,QIAO Z,LU Y,et al. Influence of fatty liver on the severity and clinical outcome in acute pancreatitis[J]. PLo S One,2015,10(11):e0142278.

[32] CAI ZZ,LI ZX. Research progress in the pathogenesis of chronic alcoholic pancreatitis[J]. Foreign Medicine(Digestive Diseases),2005,25(6):391-394.(in Chinese)蔡振寨，李兆申．酒精性慢性胰腺炎发病机制研究进展[J]．国外医学(消化系疾病分册)，2005,25(6):391-394.

[33] ZHOU XC,TANG CW,LIU CL. Moderate diet protein intake slows down progression of alcoholic pancreatic acinar cell retrogression[J]. Pancreatology,2006,6(2):69-73.(in Chinese)周旭春，唐承薇，刘纯伦．蛋白质摄入量在酒精性胰腺损伤中的作用[J]．胰腺病学，2006,6(2):69-73.

[34] ZHAO QL,HUANG CY,LI XM. Study on the mechanism of alcohol induced pancreatitis[J]. Chin J Pancreatol,2007,7(1):49-51.(in Chinese)赵秋玲，黄承钰，李晓明．酒精致胰腺炎的机制研究[J]．胰腺病学，2007,7(1):49-51.

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Clinical and prognostic features of acute alcoholic pancreatitis

DOI: 10.3969/j.issn.1001-5256.2019.11.027