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Acute biliary pancreatitis: focus on recurrence rate and costs when current guidelines are not complied.

Abstract：

BACKGROUND:International guidelines recommend cholecystectomy within 2-4 weeks after mild to moderate acute biliary pancreatitis (ABP) to prevent recurrence. We aimed to investigate the compliance to guidelines concerning early cholecystectomy and the associated costs. METHODS:Admissions for ABP 2011-2013 were retrospectively reviewed. Classification was made according to the revised Atlanta classification. Treatment, time to surgery and recurrence, as well as cost analysis for both in-hospital costs and loss of production (LOP) were performed. RESULTS:In total, 254 patients were included. Some 202 of the ABP patients (80%) underwent definitive treatment during their first attack of ABP (68% cholecystectomy, 17% endoscopic retrograde cholangiopancreatography (ERCP), 15% both interventions) and 186 (73%) were treated within 1 month of discharge. Patients with ERCP alone were significantly older than cholecystectomy cases (p < .001), but no significant difference was observed between those who underwent ERCP or no treatment (p = .071). Mild ABP had intervention earlier (p < .001). In all, 52 patients (20%) had no intervention, out of which 15 were readmitted due to pancreatitis, compared to 3 patients of those treated at the initial admission (p < .001). The mean cost for hospital care and LOP in mild ABP was €6882 ± 3010 and €9580 ± 7047 for moderate ABP (p = .001). The cost for a recurrent episode was €16,412 ± 22,367. CONCLUSION:By improved compliance to current guidelines concerning the management of ABP, recurrence rate and associated costs can potentially be reduced.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Ragnarsson T,Andersson R,Ansari D,Persson U,Andersson B

doi

10.1080/00365521.2016.1243258

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

264-269

issue

3

eissn

0036-5521

issn

1502-7708

journal_volume

52

pub_type

杂志文章

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