Pancreatic functional impairment following acute necrotizing pancreatitis: Long-term outcome of a non-surgically treated series

Objectives: Patients who Survive an episode of acute necrotizing pancreatitis may develop endocrine and exocrine pancreatic functional impairment; often these patients have undergone pancreatic Surgery during the acute episode. Aim of this study is to report the results Of a long-term follow-up of patients recovering from an episode of acute necrotizing pancreatitis which had not been treated surgically during the index hospital admission. Design and subjects: Sixty-five consecutive patients enrolled between January 1990 and December 1993, prospectively followed through December 2006. Results: Median follow-up period was 179.5 months (range 156-203). 40 patients (61.5%) who completed follow-up were analysed. Endocrine function: 2 patients (5%)were diabetic before the pancreatitis episode, and 6 (15.7%) developed overt diabetes: diabetes appeared within the 3rd year after acute pancreatitis in 2 patients, between the 3rd and 4th year in 2 patients, and between the 5th and 6th year in the last 2 patients. Exocrine function: 9 patients (22.5%) showed fecal elastase impairment: in all patients ultrasound was normal and fecal elastase returned above the normal limit during follow-up. Conclusions: After an episode of acute necrotizing pancreatitis treated without Surgery, the endocrine and exocrine function is not frequently impaired after long-term follow-up. Reduction in exocrine function is transient and complete recovery is achieved in ail patients within a few years. (C) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.