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KMID : 0614620150650050297
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Korean Journal of Gastroenterology
2015 Volume.65 No. 5 p.297 ~ p.305
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Does Endoscopic Sphincterotomy and/or Cholecystectomy Reduce Recurrence Rate of Acute Biliary Pancreatitis?
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Bang Ki-Bae
Kim Hong-Joo
Cho Yong-Kyun
Jeon Woo-Kyu
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Abstract
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Background/Aims: Practice guidelines from international societies have recommended cholecystectomy during the same hospital-ization for acute biliary pancreatitis (ABP). The aim of this study is to investigate the question of whether endoscopic sphincterotomy (EST) and/or cholecystectomy during the same hospitalization can reduce the recurrence rate of ABP.
Methods: A total of 119 patients with ABP admitted to our institution between May 2005 and May 2010 who had complete follow-up data until May 2012 were enrolled.
Results: No significant differences in initial CT severity index and Charlson comorbidity index were observed between EST (n=64) and non-EST group (n=55) and among subgroups classified according to interventions performed. In Kaplan-Meier analyses, significantly higher recurrence rates of ABP were observed in the non-EST group compared to the EST group (p＜0.01), and in the conservative treatment group compared to other intervention groups (p＜0.01). The frequency of complications from ABP was significantly higher in the conservative treatment group (35.7%) and lowest in the EST plus cholecystectomy group (5.0%, p=0.008). In multivariate analysis, conservative treatment without EST and/or cholecystectomy, and non-EST group were independent risk factors for recurrence after the initial attack of ABP.
Conclusions: ERCP with EST and cholecystectomy during the index admission is associated with reduced recurrence rates of ABP.
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KEYWORD
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Acute biliary pancreatitis, Recurrence, Endoscopic sphincterotomy, Cholecystectomy
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