Cavallini G, Frulloni L, Bassi C, Gabbrielli A, Castoldi L, Costamagna G, De Rai P, Di Carlo V, Falconi M, Pezzilli R, Uomo G
Department of Surgical and Gastroenterological Sciences, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy.
Dig Liver Dis. 2004 Mar;36(3):205-11. doi: 10.1016/j.dld.2003.11.027.
Till now, no Italian studies providing information on acute pancreatitis have been published. The aim of this study was to evaluate the epidemiological and clinical characteristics of acute pancreatitis in Italy.
The study involved 37 Italian centres distributed homogeneously throughout the entire national territory and prospectively collected epidemiological, anamnestic, laboratory, radiological, therapeutic (pharmacological, endoscopic and surgical) data, relevant to each individual case of acute pancreatitis consecutively observed during the period from September 1996 to June 2000.
One thousand two hundred and six case report forms were collected, but 201 patients (16.6%) were subsequently eliminated from the final analysis. We therefore studied 1005 patients, 533 (53%) males and 472 (47%) females, mean age 59.6 +/- 20 years. On the basis of the Atlanta classification of acute pancreatitis, 753 patients of the 1005 cases analysed (75%) were mild and 252 patients (25%) severe. The aetiology was biliary in 60% of the patients, related to alcohol abuse in 8.5%, while in 21% of the cases it could not be identified. Over 80% of the patients (83%) were admitted to hospital within 24 h from the onset of clinical symptoms, while only 6% were admitted after 48 h. In particular, 65% of the patients were admitted to hospital within the first 12 h. Antibiotics were used in 85% of the severe and 75% of mild forms. Endoscopic therapy was carried out in 65% of the severe cases, but only in 40% it was carried out prior to 72 h. Eighty-five patients (8.5% of the total, 34% of the severe forms) underwent surgical intervention: 20% on the first day, 38.5% within the fourth day, and the remaining (41.5% of the cases) later on for infected necrosis. The mean duration of hospitalisation for patients with mild pancreatitis was 13 +/- 8 days, while for the severe disease it was of 30 +/- 14 days. The overall mortality rate was 5%, 17% in severe and 1.5% in mild pancreatitis.
Acute pancreatitis in Italy is more commonly a mild disease with a biliary aetiology. The treatment of the disease is not optimal and, on the basis of these data, needs to be standardised. Despite this, the overall mortality rate is low (5%).
迄今为止，尚无关于急性胰腺炎的意大利研究发表。本研究旨在评估意大利急性胰腺炎的流行病学和临床特征。
该研究涉及分布在意大利全国领土上的37个中心，前瞻性收集了1996年9月至2000年6月期间连续观察到的每例急性胰腺炎患者的流行病学、既往史、实验室、放射学、治疗（药物、内镜和手术）数据。
收集了1206份病例报告表，但随后有201例患者（16.6%）被排除在最终分析之外。因此，我们研究了1005例患者，其中男性533例（53%），女性472例（47%），平均年龄59.6±20岁。根据亚特兰大急性胰腺炎分类，在分析的1005例病例中，753例患者（75%）为轻症，252例患者（25%）为重症。病因方面，60%的患者为胆源性，8.5%与酒精滥用有关，而21%的病例病因不明。超过80%的患者（83%）在临床症状出现后24小时内入院，而只有6%在48小时后入院。特别是，65%的患者在最初12小时内入院。85%的重症患者和75%的轻症患者使用了抗生素。65%的重症病例进行了内镜治疗，但只有40%在72小时之前进行。85例患者（占总数的8.5%，重症病例的34%）接受了手术干预：20%在第一天，38.5%在第四天内，其余（41.5%的病例）后来因感染性坏死进行手术。轻症胰腺炎患者的平均住院时间为13±8天，而重症患者为30±14天。总体死亡率为5%，重症胰腺炎为17%，轻症胰腺炎为1.5%。
意大利的急性胰腺炎通常为轻症，病因多为胆源性。该病的治疗并不理想，基于这些数据，需要进行标准化。尽管如此，总体死亡率较低（5%）。
