Pancreatic functional impairment following acute necrotizing pancreatitis: long-term outcome of a non-surgically treated series.
OBJECTIVE
Patients who survive an episode of acute necrotizing pancreatitis may develop endocrine and exocrine pancreatic functional impairment; often these patients have undergone pancreatic surgery during the acute episode. Aim of this study is to report the results of a long-term follow-up of patients recovering from an episode of acute necrotizing pancreatitis which had not been treated surgically during the index hospital admission.


METHODS
Sixty-five consecutive patients enrolled between January 1990 and December 1993, prospectively followed through December 2006.


RESULTS
Median follow-up period was 179.5 months (range 156-203). 40 patients (61.5%) who completed follow-up were analysed. Endocrine function: 2 patients (5%) were diabetic before the pancreatitis episode, and 6 (15.7%) developed overt diabetes; diabetes appeared within the 3rd year after acute pancreatitis in 2 patients, between the 3rd and 4th year in 2 patients, and between the 5th and 6th year in the last 2 patients. Exocrine function: 9 patients (22.5%) showed fecal elastase impairment; in all patients ultrasound was normal and fecal elastase returned above the normal limit during follow-up.


CONCLUSIONS
After an episode of acute necrotizing pancreatitis treated without surgery, the endocrine and exocrine function is not frequently impaired after long-term follow-up. Reduction in exocrine function is transient and complete recovery is achieved in all patients within a few years.
Uomo
G
G
Internal Medicine Department, Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy. generoso.uomo@ospedalecardarelli.it
Gallucci
F
F
Madrid
E
E
Miraglia
S
S
Manes
G
G
Rabitti
P G
PG
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000209:etiology; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000502:physiology*; D010196:Pancreatic Elastase / Q000032:analysis; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000534:rehabilitation* / Q000628:therapy; D011446:Prospective Studies; D020127:Recovery of Function; D017741:Survivors
D010196:Pancreatic Elastase