Cui Mei Lan, Kim Kook Hyun, Kim Ho Gak, Han Jimin, Kim Hyunsoo, Cho Kwang Bum, Jung Min Kyu, Cho Chang Min, Kim Tae Nyeun
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung 5-dong Nam-gu, Taegu, 705-717, Korea,
Dig Dis Sci. 2014 May;59(5):1055-62. doi: 10.1007/s10620-013-2967-4. Epub 2013 Dec 11.
Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems. Acute fluid collections and pseudocyst formation are the most frequent complications of acute pancreatitis.
The aims of this study were to evaluate the incidence, risk factors, and clinical course of pancreatic fluid collections and pseudocyst formation following acute pancreatitis.
A prospective multicenter study was conducted in five participating centers with 302 patients diagnosed with acute pancreatitis from January 2011 to July 2012.
The incidence of pancreatic fluid collections and pseudocyst was 42.7 and 6.3 %, respectively. Patients with fluid collections were significantly younger, compared to those without fluid collections (51.5 ± 15.9 vs. 60.4 ± 16.5 years, P = 0.000). The proportion of alcoholic etiology (54.3 %) in patients with fluid collections was significantly higher compared to other etiologies (P = 0.000). C-reactive protein (CRP) (48 h) was significantly higher in patients with fluid collections, compared to patients without fluid collections (39.2 ± 77.4 vs. 15.1 ± 36.2 mg/dL, P = 0.016). LDH (48 h) was significantly higher in patients with pseudocyst formation, compared to patients with complete resolution (1,317.6 ± 706.4 vs. 478.7 ± 190.5 IU/L, P = 0.000). Pancreatic fluid collections showed spontaneous resolution in 69.8 % (90/129) and 84.2 % of the pseudocysts disappeared or decreased in size during follow up.
Age, CRP (48 h), and alcohol etiology are risk factors for pancreatic fluid collections. LDH (48 h) appears to be a risk factor for pseudocyst formation. Most pseudocysts showed a decrease in size or spontaneous resolution with conservative management.
急性胰腺炎是胰腺的一种急性炎症过程，可不同程度累及其他局部组织或远隔器官系统。急性液体积聚和假性囊肿形成是急性胰腺炎最常见的并发症。
本研究旨在评估急性胰腺炎后胰液积聚和假性囊肿形成的发生率、危险因素及临床病程。
在五个参与中心进行了一项前瞻性多中心研究，纳入了2011年1月至2012年7月期间诊断为急性胰腺炎的302例患者。
胰液积聚和假性囊肿的发生率分别为42.7%和6.3%。有液体积聚的患者比没有液体积聚的患者明显年轻（51.5±15.9岁对60.4±16.5岁，P = 0.000）。有液体积聚的患者中酒精性病因的比例（54.3%）明显高于其他病因（P = 0.000）。有液体积聚的患者48小时的C反应蛋白（CRP）明显高于没有液体积聚的患者（39.2±77.4对15.1±36.2mg/dL，P = 0.016）。与完全消退的患者相比，形成假性囊肿的患者48小时的乳酸脱氢酶（LDH）明显更高（1317.6±706.4对478.7±190.5IU/L，P = 0.000）。随访期间，69.8%（90/129）的胰液积聚自行消退，84.2%的假性囊肿消失或缩小。
年龄、48小时的CRP和酒精性病因是胰液积聚的危险因素。48小时的LDH似乎是假性囊肿形成的危险因素。大多数假性囊肿经保守治疗后体积缩小或自行消退。
