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@article{1081086, author = {Trna, Jan and Vege, Santhi Swaroop and Příbramská, Veronika and Chari, Suresh T. and Kamath, Patrick S. and Kendrick, Michael L. and Farnell, Michael B.}, article_number = {2}, doi = {http://dx.doi.org/10.1016/j.surg.2011.07.017}, keywords = {enzyme; liver; gallstones}, language = {eng}, issn = {0039-6060}, journal = {Surgery}, title = {Lack of significant liver enzyme elevation and gallstones and/or sludge on ultrasound on day 1 of acute pancreatitis is associated with recurrence after cholecystectomy: A population-based study}, volume = {151}, year = {2012} }
TY - JOUR ID - 1081086 AU - Trna, Jan - Vege, Santhi Swaroop - Příbramská, Veronika - Chari, Suresh T. - Kamath, Patrick S. - Kendrick, Michael L. - Farnell, Michael B. PY - 2012 TI - Lack of significant liver enzyme elevation and gallstones and/or sludge on ultrasound on day 1 of acute pancreatitis is associated with recurrence after cholecystectomy: A population-based study JF - Surgery VL - 151 IS - 2 SP - 199–205 EP - 199–205 SN - 00396060 KW - enzyme KW - liver KW - gallstones N2 - In a population-based study, we examined recurrence rates of acute pancreatitis (AP) after cholecystectomy performed to prevent recurrences of AP. Methods We abstracted data from medical records of all Olmsted county residents who underwent cholecystectomy at Mayo Clinic for the management of presumed gallstone or idiopathic AP between 1990 and 2005 (n = 239). Based on (i) significantly elevated liver enzymes (threefold increase of alanine aminotransferase or aspartate aminotransferase) on day 1 and (ii) the presence of gallstones/sludge in the gall bladder, we categorized patients into 4 groups: A (i + ii), B (i but not ii), C (ii but not i), and D (neither i nor ii). Recurrence rates of AP after cholecystectomy were determined in all groups. Results The median follow-up after cholecystectomy was 99 months (range, 8–220). AP recurred in 13 of 142 patients (9%) in group A, 1 of 17 patients (6%) in group B, 13 of 57 patients (23%) in group C, and 14 of 23 patients (61%) in group D (P < .0001 D vs all other groups and P = .001 C vs groups A and B). No difference was seen in recurrence rates in groups A vs B (P = 1.0). Recurrences were more frequent in patients with normal liver enzymes (A + B vs C + D; P = .000003) and in patients without sonographic evidence of gallstones/sludge (A + C vs B + D; P = .0008). Conclusion When AP is associated with significantly elevated liver enzymes on day 1, recurrence rates after cholecystectomy are low (9%). However, postcholecystectomy recurrence rates of AP are high in those without such laboratory abnormalities (34%), especially in those without gall bladder stones/sludge (61%) on abdominal ultrasonography. Our results raise doubts about the efficacy of cholecystectomy to prevent recurrent AP in patients with the absence of either a significant elevation of liver tests on day 1 of AP or gallstones and/or sludge in the gall bladder on initial ultrasound examination. ER -
TRNA, Jan, Santhi Swaroop VEGE, Veronika PŘÍBRAMSKÁ, Suresh T. CHARI, Patrick S. KAMATH, Michael L. KENDRICK a Michael B. FARNELL. Lack of significant liver enzyme elevation and gallstones and/or sludge on ultrasound on day 1 of acute pancreatitis is associated with recurrence after cholecystectomy: A population-based study. \textit{Surgery}. 2012, roč.~151, č.~2, s.~199–205. ISSN~0039-6060. Dostupné z: https://dx.doi.org/10.1016/j.surg.2011.07.017.
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