The causes of acute recurrent pancreatitis and endoscopic therapy

Objective To analyze the causes of patients with acute recurrent pancreatitis (RAP), efficacy of endoscopic therapy and prognosis.

Methods The clinical data of 127 patients with RAP admitted from October 2018 to October 2020 were retrospectively analyzed. According to different treatment methods, the patients were divided into endoscopic group (endoscopic treatment, n=46), drug group (drug treatment, n=33) and surgery group (surgical treatment, n=48). The causes of the three groups were analyzed. The average recurrence times before admission, the time from the first attack to admission, and the recurrence rate within 3 years before operation were compared among the three groups. The prognosis, recurrence and death of the three groups were analyzed.

Results Biliary calculus was the most common cause of RAP, accounting for 30.71% (39/127), followed by hyperlipidemia, accounting for 24.41% (31/127). There were no significant differences in etiology, average recurrence times before admission, time from the first attack to admission, recurrence rate within 3 years before operation, cure rate, improvement rate and ineffective rate among the three groups (P>0.05). All patients in the endoscopic group were cured or improved after treatment, without aggravation. The physical, role, emotion, cognition and social function scores in the endoscopic group were significantly higher than those in the drug group and surgery group (P < 0.05). During follow-up, the recurrence rate of the endoscopy group was significantly lower than that of the drug group and surgery group (P < 0.05).

Conclusion The main pathogenic factors of RAP are biliary factor, hyperlipidemia and alcohol. Endoscopic treatment can effectively reduce the recurrence rate and improve the prognosis of RAP patients.