Repeat Gallstone Pancreatitis High Without Intervention
(HealthDay News) – The risk of recurrence is significant in patients who do not receive cholecystectomy for treatment of acute gallstone pancreatitis, according to a study published online July 24 in JAMA Surgery.
Stephanie S. Hwang, MD, from the Kaiser Permanente Los Angeles Medical Center, and colleagues retrospectively analyzed electronic medical records of all hospitalized patients with a primary diagnosis of acute gallstone pancreatitis (Jan. 1, 1995, through Dec. 31, 2010) for whom this was the first diagnosis of gallstone pancreatitis (1,119 patients; mean age, 63 years). Patients received endoscopic retrograde cholangiopancreatography (ERCP; 317 patients) with or without sphincterotomy and/or stent placement, or no intervention (802 patients).
The researchers found that, after a median 2.3 years of follow-up, the overall risk of recurrent pancreatitis was 14.6%. The risk was 8.2% in patients who had ERCP and 17.1% in patients with no intervention, with a median time to recurrence of 11.3 and 10.1 months, respectively. In the ERCP group, Kaplan-Meier estimates of recurrence for one, two, and five years were 5.2%, 7.4%, and 11.1%, respectively, compared to 11.3%, 16.1%, and 22.7%, respectively, in the no-intervention group (hazard ratio, 0.45).
"In patients who did not undergo cholecystectomy, the risk of recurrent pancreatitis is significant," the authors write. "Endoscopic retrograde cholangiopancreatography mitigates this risk and should be considered during initial hospitalization if cholecystectomy is not done."