Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis

Background and Aims: Cholecystectomy is recommended to prevent recurrence of biliary pancreatitis, but supporting evidence is limited for sludge- and microlithiasis-induced acute pancreatitis (AP). This study aimed to compare relapse patterns and risk factors between patients with sludge/microlithia...

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Detalles Bibliográficos
Autores: Sirtl, S, Teodorescu, B, Gilberg, L, Schäfer, A, Beyer, G, Arnau, A, López-Guillén, P, Martinez-Dominguez, SJ, Baroja, DA, Oyón, D, Ruiz-Belmonte, LM, Tejedor-Tejada, J, Zapater, R, Martin-Vicente, N, Fernández-Esparcia, PJ, Gomara, ABJ, Lozano, VS, Garcia, JJM, Martin-Falquina, IC, Pascual, LA, Monclus, NT, Velasco, NZ, Rojo, E, Lapeña-Muñoz, B, Flores, V, Gómez, AD, Cañamares-Orbis, P, Abizanda, IV, Carrasco, NM, Grau, LP, Garcia-Rayado, G, Bocos, JM, Paredes, AGGD, Lorenzo, MV, Arostegi, AI, Lozada-Hernández, EE, Velasco, JAVR, Zorniak, M, de-Madaria, E, Mayerle, J, Velamazán, R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p11309
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones11309
http://doi.org.10.1016/j.dld.2025.06.005
Access Level:acceso abierto
Palabra clave:Acute pancreatitis
Biliary pancreatitis
Gallstones
Microlithiasis
Sludge
Descripción
Sumario:Background and Aims: Cholecystectomy is recommended to prevent recurrence of biliary pancreatitis, but supporting evidence is limited for sludge- and microlithiasis-induced acute pancreatitis (AP). This study aimed to compare relapse patterns and risk factors between patients with sludge/microlithiasis-induced AP and gallstone-induced AP. Methods: This analysis included 789 patients from the international, multicenter Relapstone cohort (Spain: 16 centers; Mexico: 2 centers), hospitalized between January 2018 and April 2020 with firsttime biliary AP and no cholecystectomy during admission. Patients with sludge/microlithiasis-induced AP ( n = 274) were compared to those with gallstone-induced AP ( n = 515) regarding pancreatobiliary complications. Multivariate analysis was used to assess relapse risk factors. Results: Pancreatobiliary complications occurred in 41.7 % of the gallstone cohort versus 32.1 % in the sludge/microlithiasis cohort ( p = 0.01). Correspondingly, the gallstone AP cohort showed a significantly lower complication-free survival rate (log-rank p = 0.0022; median follow-up: 6.1 vs. 8.1 months). In multivariate analysis, older age in the gallstone group was significantly associated with lower relapse risk Conclusion: This multicenter study reveals distinct differences in relapse risk between gallstone- and sludge/microlithiasis-induced AP, with gallstone AP showing a higher rate of complications in the absence of cholecystectomy. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )

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