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  • Review Article
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Acute pancreatitis: risk of recurrence and late consequences of the disease

Abstract

Research into the clinical management of acute pancreatitis has primarily focused on the immediate complications of the disease, whereas its late consequences have received less attention. These late sequelae of acute pancreatitis refer to complications that arise after the convalescence period, which lasts for 3–6 months after the initial episode. In patients who do not undergo necrosectomy that involves removal of the exocrine gland, pancreatic exocrine function usually improves rather than deteriorates during follow-up. By contrast, glucose intolerance is likely to worsen over time in all patients with acute pancreatitis. Despite the risk of late complications for patients with acute pancreatitis, their long-term quality of life is usually good. The number of pancreatitis episodes a patient has experienced is an important factor that determines the severity of late complications of acute pancreatitis. Risk factors for the recurrence of acute pancreatitis episodes have now been identified. This Review focuses on data from studies that investigated the risk factors for recurrent attacks of acute pancreatitis, and discusses the late consequences of this disease.

Key Points

  • Prevention of recurrent attacks of acute pancreatitis is dependent on the etiology of disease; early treatment of gallstones and repeated interventions to encourage abstinence from alcohol can help

  • Insufficient pancreatic exocrine function is common after recovery from acute pancreatitis, but this parameter typically improves over time

  • Pancreatic endocrine function slowly worsens in patients, even after apparent recovery from acute pancreatitis

  • Long-term quality of life for patients is usually good, even for those with severe acute pancreatitis

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Figure 1: Initial and late consequences of acute pancreatitis.
Figure 2: CT image of a chronic pseudocyst.

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Acknowledgements

The authors would like to thank Virginia Mattila, Tampere University, Finland, for providing linguistic assistance with this manuscript.

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Sand, J., Nordback, I. Acute pancreatitis: risk of recurrence and late consequences of the disease. Nat Rev Gastroenterol Hepatol 6, 470–477 (2009). https://doi.org/10.1038/nrgastro.2009.106

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