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

J 2012

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

TRNA, Jan; Santhi Swaroop VEGE; Veronika PŘÍBRAMSKÁ; Suresh T. CHARI; Patrick S. KAMATH et al.

Základní údaje

Originální název

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

Autoři

TRNA, Jan; Santhi Swaroop VEGE; Veronika PŘÍBRAMSKÁ; Suresh T. CHARI; Patrick S. KAMATH; Michael L. KENDRICK a Michael B. FARNELL

Vydání

Surgery, 2012, 0039-6060

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Irsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.373

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/12:00062712

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1016/j.surg.2011.07.017

UT WoS

000299607800008

Klíčová slova anglicky

enzyme; liver; gallstones

Změněno: 11. 1. 2013 15:08, Mgr. Michal Petr

Anotace

V originále

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.

Citovat

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. Surgery. 2012, roč. 151, č. 2, s. 199–205. ISSN 0039-6060. Dostupné z: https://doi.org/10.1016/j.surg.2011.07.017.

@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 = {https://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://doi.org/10.1016/j.surg.2011.07.017.

Přehled o publikaci