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

作者：Ragnarsson Tim; Andersson Roland; Ansari Daniel; Persson Ulf; Andersson Bodil

来源：Scandinavian Journal of Gastroenterology, 2017, 52(3): 264-269.

DOI：10.1080/00365521.2016.1243258

• Acute biliary pancreatitis
• costs
• loss of production
• recurrence

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 (sic)68823010 and (sic)9580 +/- 7047 for moderate ABP (p=.001). The cost for a recurrent episode was (sic)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.

• 出版日期2017