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. 2024 Sep 1;53(8):e633-e640.
doi: 10.1097/MPA.0000000000002349. Epub 2024 May 1.

Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis-All of the Same?

Simon Sirtl  1 , Katharina Bretthauer  1 , Mahmood Ahmad  1 , Eric Hohmann  1 , Vanessa F Schmidt  2 , Prince Allawadhi  1 , Marlies Vornhülz  1 , Sarah Klauss  1 , Elisabetta Goni  1 , Jakob Vielhauer  1 , Elisabeth Orgler  1 , Didem Saka  1 , Mathilda Knoblauch  3 , Felix O Hofmann  3 , Jörg Schirra  1 , Christian Schulz  1 , Georg Beyer  1 , Ujjwal M Mahajan  1 , Julia Mayerle  1 , Michal Zorniak
Affiliations

Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis-All of the Same?

Simon Sirtl et al. Pancreas. .

Abstract

Background/aim: Severity of microlithiasis- and sludge-induced pancreatitis in comparison to gallstone-induced pancreatitis has never been studied for a lack of definition.

Materials and methods: In this retrospective cohort study, 263 patients with acute biliary pancreatitis treated at a tertiary care center from 2005 to 2021 were stratified according to the recent consensus definition for microlithiasis and sludge. The gallstone-pancreatitis cohort was compared to microlithiasis, sludge, and suspected stone passage pancreatitis cohorts in terms of pancreatitis outcome, liver function, and endosonography/endoscopic retrograde cholangiopancreatography results using one-way analysis of variance and χ 2 test. Multinomial logistic regression analysis was performed to correct for bias.

Results: Microlithiasis- and sludge-induced pancreatitis, classified according to the revised Atlanta classification, did not present with a milder course than gallstone-induced pancreatitis ( P = 0.62). Microlithiasis and sludge showed an increase in bilirubin on the day of admission to hospital, which was not significantly different from gallstone-induced pancreatitis ( P = 0.36). The likelihood of detecting biliary disease on endosonography resulting in bile duct clearance was highest on the day of admission and day 1, respectively.

Conclusions: Microlithiasis and sludge induce gallstone-equivalent impaired liver function tests and induce pancreatitis with similar severity compared with gallstone-induced acute biliary pancreatitis.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Beyer G, Hoffmeister A, Michl P, et al. S3-Leitlinie Pankreatitis – Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – September 2021 – AWMF Registernummer 021-003. Z Gastroenterol . 2022;60:419–521.
    1. van Geenen EJM, van der Peet DL, Bhagirath P, et al. Etiology and diagnosis of acute biliary pancreatitis. Nat Rev Gastroenterol Hepatol . 2010;7:495–502.
    1. Lerch MM, Saluja AK, Rünzi M, et al. Pancreatic duct obstruction triggers acute necrotizing pancreatitis in the opossum. Gastroenterology . 1993;104:853–861.
    1. Venneman NG, Buskens E, Besselink MGH, et al. Small gallstones are associated with increased risk of acute pancreatitis: potential benefits of prophylactic cholecystectomy? Am J Gastroenterol . 2005;100:2540–2550.
    1. Venneman NG, Renooij W, Rehfeld JF, et al. Small gallstones, preserved gallbladder motility, and fast crystallization are associated with pancreatitis. Hepatology . 2005;41:738–746.

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