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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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
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spelling Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitisSirtl, STeodorescu, BGilberg, LSchäfer, ABeyer, GArnau, ALópez-Guillén, PMartinez-Dominguez, SJBaroja, DAOyón, DRuiz-Belmonte, LMTejedor-Tejada, JZapater, RMartin-Vicente, NFernández-Esparcia, PJGomara, ABJLozano, VSGarcia, JJMMartin-Falquina, ICPascual, LAMonclus, NTVelasco, NZRojo, ELapeña-Muñoz, BFlores, VGómez, ADCañamares-Orbis, PAbizanda, IVCarrasco, NMGrau, LPGarcia-Rayado, GBocos, JMParedes, AGGDLorenzo, MVArostegi, AILozada-Hernández, EEVelasco, JAVRZorniak, Mde-Madaria, EMayerle, JVelamazán, RAcute pancreatitisBiliary pancreatitisGallstonesMicrolithiasisSludgeBackground 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/ )ELSEVIER SCIENCE INC2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones11309http://doi.org.10.1016/j.dld.2025.06.005DIGESTIVE AND LIVER DISEASEISSN: 15908658ISSNe: 18783562reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p113092026-06-12T10:20:37Z
dc.title.none.fl_str_mv Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
title Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
spellingShingle Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
Sirtl, S
Acute pancreatitis
Biliary pancreatitis
Gallstones
Microlithiasis
Sludge
title_short Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
title_full Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
title_fullStr Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
title_full_unstemmed Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
title_sort Lower rate of pancreatobiliary complications after sludge and microlithiasis pancreatitis compared to gallstone pancreatitis
dc.creator.none.fl_str_mv 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
author Sirtl, S
author_facet 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
author_role author
author2 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
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acute pancreatitis
Biliary pancreatitis
Gallstones
Microlithiasis
Sludge
topic Acute pancreatitis
Biliary pancreatitis
Gallstones
Microlithiasis
Sludge
description 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/ )
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones11309
http://doi.org.10.1016/j.dld.2025.06.005
url https://isabial.portalinvestigacion.com/publicaciones11309
http://doi.org.10.1016/j.dld.2025.06.005
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv DIGESTIVE AND LIVER DISEASE
ISSN: 15908658
ISSNe: 18783562
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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