72001 - Incidence, epidemiology, and management of severe biliary pancreatitis

Introduction

According to Swedish guidelines, more than 4700 individuals are affected by acute pancreatitis yearly, with approximately 6000 admissions. Previous studies show that 7,5-10% of all pancreatitis are severe, defined as persistent organ insufficiency for more than 48 h. Approximately 40% of all cases are caused by gallstones.

The aim of the present study was to investigate the incidence of severe acute biliary pancreatitis (ABP), associated risk factors, impact of minimally invasive treatments on patients outcomes in our institution.

Method

All patients admitted to Sahlgrenska university hospital with ABP between 2018-2022 were included. Data was collected from patient records. Risk factors for severe disease like ASA-classification, age (>65), and gender were analyzed. Hospital stay, additional interventions after discharge and minimally invasive treatment as EUS, ERCP and PTBD were recorded.

Result

Of 242 patients, 24 (9,9%) presented with severe pancreatitis. In a multivariate logistic regression model ASA-classification (OR: 3.21, 95% CI: 1.18-8.68), age (OR: 1.05, 95% CI: 0.39-2.87) and female gender (OR: 2.18, 95% CI: 0.85-5.55) were independently associated with severe pancreatitis.

23 patients were treated using some minimally invasive procedure of whom 43% with EUS, 43% underwent ERCP, and 13% had PTBD. The median time of hospital stay was 46.5 days (4–267) and 16 patients returned for additional intervention after discharge.

Discussion

Severe pancreatitis in our institution is 10% of all ABPs, with high morbidity, leading to prolonged hospital stay and demands great amounts of recourses and interventional methods that require expertise.