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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Detalhes bibliográficos
Autores: Sirtl, Simon, Teodorescu, Bianca, Gilberg, Leonard, Schafer, Arlett, Beyer, Georg, Arnau, Anna, Lopez-Guillen, Pablo, Martinez-Dominguez, Samuel J., Baroja, Daniel Abad, Oyon, Daniel, Ruiz-Belmonte, Lara M., Tejedor-Tejada, Javier, Zapater, Raul, Martin-Vicente, Noelia, Fernandez-Esparcia, Pedro Jose, Gomara, Ana Belen Julian, Lozano, Violeta Sastre, Garcia, Juan Jose Manzanares, Martin-Falquina, Irene Chivato, Pascual, Laura Andres, Monclus, Nuria Torres, Velasco, Natividad Zaragoza, Rojo, Eukene, Lapena-Munoz, Berta, Flores, Virginia, Gomez, Arantxa Diaz, Canamares-Orbis, Pablo, Abizanda, Isabel Vinzo, Carrasco, Natalia Marcos, Grau, Laura Pardo, Garcia-Rayado, Guillermo, Bocos, Judith Millastre, Paredes, Ana Garcia Garcia de, Lorenzo, Maria Vaamonde, Arostegi, Arantzazu Izagirre, Lozada-Hernandez, Edgard Efren, Velasco, Jose Antonio Velarde-Ruiz, Zorniak, Michal, de-Madaria, Enrique, Mayerle, Julia, Velamazan, Raul
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p19344
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/19344
Access Level:acceso abierto
Palavra-chave:Acute pancreatitis
Biliary pancreatitis
Gallstones
Microlithiasis
Sludge
Descrição
Resumo: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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