Outcomes after treatment for patients with idiopathic acute pancreatitis

W. L. Knapple, P. R. Tarnasky, K. G. Yeoh, P. D. Mauldin, E. Rawls, John T Cunningham, P. B. Cotton, R. H. Hawes

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Abstract

No cause is found at routine evaluation in up to 40% of patients with recurrent acute pancreatitis. Very little has been reported regarding outcomes after therapy in these patients. Purpose: To assess outcomes of endoscopic treatment in patients referred for ERCP with a diagnosis of idiopathic acute pancreatitis (IAP). Methods: 67 consecutive patients with IAP had ERCP with endoscopic therapy and at least 6mo follow-up. Patients were surveyed (mail or phone) regarding their global condition (excellent, good, fair, poor, terrible), severity (0=no pain to 10=unbearable) of attacks, and number of medical encounters for 6mo periods before and after therapy. Patients were also asked to assess (5 point Likert scale) the change in their overall condition (much improved to much worse) and satisfaction with care (very satisfied to very dissatisfied). Complications after therapy were graded (Gastrointest Endosc. 1991;37:383-393). Results: Forty-six patients (69%) have completed the survey to date. Ten patients had one attack and 36 had recurrent attacks of IAP. There were 39 females and 7 males with a mean age of 57 yrs (range 23-84). Therapy for sphincter of Oddi dysfunction (n=23), pancreas divisum (n=12), biliary (n=5), and other (n=6) included: biliary sphincterotomy (sphx) in 24(52%); biliary and pancreatic sphx in 7(15%); minor papilla therapy in 14(31%); and pancreatic sphx in 1(2%). 6mo Before Treatment 6mo After Treatment Global Condition fair to terrible 89% fair to terrible 4% good to excellent 11% good to excellent 96% Severity of Attacks x̄ 8.5(±2.4 SD) 1.7 (± 2.6 SD) Hospitalizations (≥1) 89% 23% Twenty-nine (63%) described the change in their overall condition as "much improved", 14(30%) considered their condition "somewhat improved", and 3(7%) were "unsure". Forty-one (89%) reported they were "very satisfied" with their care, while 5(11%) were "somewhat satisfied". Six (13%) had immediate post-ERCP pancreatitis (4-mild; 1-moderate; 1-severe); there were no other complications. Conclusions: At six month follow-up, endoscopic treatment for idiopathic acute pancreatitis reduces the severity of attacks and hospitalizations. The majority of patients considered their overall condition to be improved after endoscopic therapy and were satisfied with their care.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997
Externally publishedYes

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Pancreatitis
Endoscopic Retrograde Cholangiopancreatography
Therapeutics
Hospitalization
Sphincter of Oddi Dysfunction
Postal Service
Pancreas
Pain

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Knapple, W. L., Tarnasky, P. R., Yeoh, K. G., Mauldin, P. D., Rawls, E., Cunningham, J. T., ... Hawes, R. H. (1997). Outcomes after treatment for patients with idiopathic acute pancreatitis. Gastrointestinal Endoscopy, 45(4).

Outcomes after treatment for patients with idiopathic acute pancreatitis. / Knapple, W. L.; Tarnasky, P. R.; Yeoh, K. G.; Mauldin, P. D.; Rawls, E.; Cunningham, John T; Cotton, P. B.; Hawes, R. H.

In: Gastrointestinal Endoscopy, Vol. 45, No. 4, 1997.

Research output: Contribution to journalArticle

Knapple, WL, Tarnasky, PR, Yeoh, KG, Mauldin, PD, Rawls, E, Cunningham, JT, Cotton, PB & Hawes, RH 1997, 'Outcomes after treatment for patients with idiopathic acute pancreatitis', Gastrointestinal Endoscopy, vol. 45, no. 4.
Knapple WL, Tarnasky PR, Yeoh KG, Mauldin PD, Rawls E, Cunningham JT et al. Outcomes after treatment for patients with idiopathic acute pancreatitis. Gastrointestinal Endoscopy. 1997;45(4).
Knapple, W. L. ; Tarnasky, P. R. ; Yeoh, K. G. ; Mauldin, P. D. ; Rawls, E. ; Cunningham, John T ; Cotton, P. B. ; Hawes, R. H. / Outcomes after treatment for patients with idiopathic acute pancreatitis. In: Gastrointestinal Endoscopy. 1997 ; Vol. 45, No. 4.
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title = "Outcomes after treatment for patients with idiopathic acute pancreatitis",
abstract = "No cause is found at routine evaluation in up to 40{\%} of patients with recurrent acute pancreatitis. Very little has been reported regarding outcomes after therapy in these patients. Purpose: To assess outcomes of endoscopic treatment in patients referred for ERCP with a diagnosis of idiopathic acute pancreatitis (IAP). Methods: 67 consecutive patients with IAP had ERCP with endoscopic therapy and at least 6mo follow-up. Patients were surveyed (mail or phone) regarding their global condition (excellent, good, fair, poor, terrible), severity (0=no pain to 10=unbearable) of attacks, and number of medical encounters for 6mo periods before and after therapy. Patients were also asked to assess (5 point Likert scale) the change in their overall condition (much improved to much worse) and satisfaction with care (very satisfied to very dissatisfied). Complications after therapy were graded (Gastrointest Endosc. 1991;37:383-393). Results: Forty-six patients (69{\%}) have completed the survey to date. Ten patients had one attack and 36 had recurrent attacks of IAP. There were 39 females and 7 males with a mean age of 57 yrs (range 23-84). Therapy for sphincter of Oddi dysfunction (n=23), pancreas divisum (n=12), biliary (n=5), and other (n=6) included: biliary sphincterotomy (sphx) in 24(52{\%}); biliary and pancreatic sphx in 7(15{\%}); minor papilla therapy in 14(31{\%}); and pancreatic sphx in 1(2{\%}). 6mo Before Treatment 6mo After Treatment Global Condition fair to terrible 89{\%} fair to terrible 4{\%} good to excellent 11{\%} good to excellent 96{\%} Severity of Attacks x̄ 8.5(±2.4 SD) 1.7 (± 2.6 SD) Hospitalizations (≥1) 89{\%} 23{\%} Twenty-nine (63{\%}) described the change in their overall condition as {"}much improved{"}, 14(30{\%}) considered their condition {"}somewhat improved{"}, and 3(7{\%}) were {"}unsure{"}. Forty-one (89{\%}) reported they were {"}very satisfied{"} with their care, while 5(11{\%}) were {"}somewhat satisfied{"}. Six (13{\%}) had immediate post-ERCP pancreatitis (4-mild; 1-moderate; 1-severe); there were no other complications. Conclusions: At six month follow-up, endoscopic treatment for idiopathic acute pancreatitis reduces the severity of attacks and hospitalizations. The majority of patients considered their overall condition to be improved after endoscopic therapy and were satisfied with their care.",
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T1 - Outcomes after treatment for patients with idiopathic acute pancreatitis

AU - Knapple, W. L.

AU - Tarnasky, P. R.

AU - Yeoh, K. G.

AU - Mauldin, P. D.

AU - Rawls, E.

AU - Cunningham, John T

AU - Cotton, P. B.

AU - Hawes, R. H.

PY - 1997

Y1 - 1997

N2 - No cause is found at routine evaluation in up to 40% of patients with recurrent acute pancreatitis. Very little has been reported regarding outcomes after therapy in these patients. Purpose: To assess outcomes of endoscopic treatment in patients referred for ERCP with a diagnosis of idiopathic acute pancreatitis (IAP). Methods: 67 consecutive patients with IAP had ERCP with endoscopic therapy and at least 6mo follow-up. Patients were surveyed (mail or phone) regarding their global condition (excellent, good, fair, poor, terrible), severity (0=no pain to 10=unbearable) of attacks, and number of medical encounters for 6mo periods before and after therapy. Patients were also asked to assess (5 point Likert scale) the change in their overall condition (much improved to much worse) and satisfaction with care (very satisfied to very dissatisfied). Complications after therapy were graded (Gastrointest Endosc. 1991;37:383-393). Results: Forty-six patients (69%) have completed the survey to date. Ten patients had one attack and 36 had recurrent attacks of IAP. There were 39 females and 7 males with a mean age of 57 yrs (range 23-84). Therapy for sphincter of Oddi dysfunction (n=23), pancreas divisum (n=12), biliary (n=5), and other (n=6) included: biliary sphincterotomy (sphx) in 24(52%); biliary and pancreatic sphx in 7(15%); minor papilla therapy in 14(31%); and pancreatic sphx in 1(2%). 6mo Before Treatment 6mo After Treatment Global Condition fair to terrible 89% fair to terrible 4% good to excellent 11% good to excellent 96% Severity of Attacks x̄ 8.5(±2.4 SD) 1.7 (± 2.6 SD) Hospitalizations (≥1) 89% 23% Twenty-nine (63%) described the change in their overall condition as "much improved", 14(30%) considered their condition "somewhat improved", and 3(7%) were "unsure". Forty-one (89%) reported they were "very satisfied" with their care, while 5(11%) were "somewhat satisfied". Six (13%) had immediate post-ERCP pancreatitis (4-mild; 1-moderate; 1-severe); there were no other complications. Conclusions: At six month follow-up, endoscopic treatment for idiopathic acute pancreatitis reduces the severity of attacks and hospitalizations. The majority of patients considered their overall condition to be improved after endoscopic therapy and were satisfied with their care.

AB - No cause is found at routine evaluation in up to 40% of patients with recurrent acute pancreatitis. Very little has been reported regarding outcomes after therapy in these patients. Purpose: To assess outcomes of endoscopic treatment in patients referred for ERCP with a diagnosis of idiopathic acute pancreatitis (IAP). Methods: 67 consecutive patients with IAP had ERCP with endoscopic therapy and at least 6mo follow-up. Patients were surveyed (mail or phone) regarding their global condition (excellent, good, fair, poor, terrible), severity (0=no pain to 10=unbearable) of attacks, and number of medical encounters for 6mo periods before and after therapy. Patients were also asked to assess (5 point Likert scale) the change in their overall condition (much improved to much worse) and satisfaction with care (very satisfied to very dissatisfied). Complications after therapy were graded (Gastrointest Endosc. 1991;37:383-393). Results: Forty-six patients (69%) have completed the survey to date. Ten patients had one attack and 36 had recurrent attacks of IAP. There were 39 females and 7 males with a mean age of 57 yrs (range 23-84). Therapy for sphincter of Oddi dysfunction (n=23), pancreas divisum (n=12), biliary (n=5), and other (n=6) included: biliary sphincterotomy (sphx) in 24(52%); biliary and pancreatic sphx in 7(15%); minor papilla therapy in 14(31%); and pancreatic sphx in 1(2%). 6mo Before Treatment 6mo After Treatment Global Condition fair to terrible 89% fair to terrible 4% good to excellent 11% good to excellent 96% Severity of Attacks x̄ 8.5(±2.4 SD) 1.7 (± 2.6 SD) Hospitalizations (≥1) 89% 23% Twenty-nine (63%) described the change in their overall condition as "much improved", 14(30%) considered their condition "somewhat improved", and 3(7%) were "unsure". Forty-one (89%) reported they were "very satisfied" with their care, while 5(11%) were "somewhat satisfied". Six (13%) had immediate post-ERCP pancreatitis (4-mild; 1-moderate; 1-severe); there were no other complications. Conclusions: At six month follow-up, endoscopic treatment for idiopathic acute pancreatitis reduces the severity of attacks and hospitalizations. The majority of patients considered their overall condition to be improved after endoscopic therapy and were satisfied with their care.

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