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. 2025 Apr 12;20(1):32.
doi: 10.1186/s13017-025-00601-x.

A systematic review of the predictive factors for the recurrence of acute pancreatitis

Daniela Pacella #  1 , Adriano De Simone #  1   2 , Adolfo Pisanu  3 , Gianluca Pellino  4 , Lucio Selvaggi  4 , Valentina Murzi  3 , Eleonora Locci  3 , Giulia Ciabatti  5 , Laura Mastrangelo  5 , Elio Jovine  5 , Matteo Rottoli  6   7 , Giacomo Calini  6 , Stefano Cardelli  6   7 , Fausto Catena  8 , Carlo Vallicelli  8 , Raffaele Bova  8 , Gabriele Vigutto  8 , Fabrizio D'Acapito  9 , Giorgio Ercolani  9 , Leonardo Solaini  9 , Alan Biloslavo  10 , Paola Germani  10 , Camilla Colutta  10 , Pasquale Lepiane  11 , Rosa Scaramuzzo  11 , Savino Occhionorelli  12 , Domenico Lacavalla  12 , Maria Grazia Sibilla  12 , Stefano Olmi  13 , Matteo Uccelli  13 , Alberto Oldani  13 , Alessio Giordano  14 , Tommaso Guagni  14 , Davina Perini  14 , Francesco Pata  15 , Bruno Nardo  15 , Daniele Paglione  15 , Giusi Franco  15 , Matteo Donadon  16 , Marcello Di Martino  16 , Salomone Di Saverio  17 , Luca Cardinali  17 , Grazia Travaglini  17 , Dario Bruzzese  1 , Mauro Podda  18
Affiliations

A systematic review of the predictive factors for the recurrence of acute pancreatitis

Daniela Pacella et al. World J Emerg Surg. .

Abstract

Purpose: Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease.

Methods: A systematic review was conducted selecting studies from BiomedCentral, PubMed, Scopus and Web of Science by two independent reviewers. Publications were considered only if written in English in the time interval between January 2000 and June 2024 and investigated the risk factors for the recurrence of BAP and AAP. At the end of the selection, a quality assessment phase was conducted using the PROBAST tool.

Results: In this systematic review, 8 articles were selected out of 6.945, involving a total sample of 11.271 patients of which 38.77% developed recurrence episodes. 37.5% of the included studies focus on recurrent acute biliary pancreatitis (RBAP), while 62.5% are dedicated to recurrent acute alcoholic pancreatitis (RAAP). The risk factors for the recurrence of AP showed a clear differentiation between the alcoholic and biliary etiology. Most of the considered studies adopted a retrospective design, characterized by a susceptibility to potential methodological biases. However, the trend indicated a more recent increase in prospective studies, together with a greater focus on identifying and understanding the possible risk factors associated with the recurrence of acute pancreatitis (RAP). This result highlighted the progress in the scientific approach toward a more rigorous and systematic assessment of the causes and dynamics that influence the recurrence of the disease.

Conclusion: Studies highlighted the importance of lifestyle factors, clinical complications, and surgical interventions that can impact the risk of biliary or alcoholic recurrent acute pancreatitis. Increased and systematic adoption of artificial intelligence-based tools could significantly impact future knowledge relating to the risks of recurrence and relative possibilities of prevention.

Keywords: Acute Pancreatitis; Alcoholic; Biliary; Recurrence; Risk factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Competing interests: The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Flowchart of articles selection
Fig. 2
Fig. 2
BIAS analysis. Red: high risk; yellow: medium risk; green: low risk
See this image and copyright information in PMC

References

    1. Bradley EL. A clinically based classification system for acute pancreatitis: summary of the international symposium on acute pancreatitis, atlanta, ga, september 11 through 13, 1992. Arch Surg. 1993;128(5):586–90. - PubMed
    1. Xiao AY, Tan ML, Wu LM, Asrani VM, Windsor JA, Yadav D, Petrov MS. Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol. 2016;1(1):45–55. - PubMed
    1. Li C-L, Jiang M, Pan C-q, Li J, Xu L-g. The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990–2019. BMC Gastroenterol. 2021;21:1–12. - PMC - PubMed
    1. Hamada S, Masamune A, Kikuta K, Hirota M, Tsuji I, Shimosegawa T, Pancreas RC, et al. Nationwide epidemiological survey of acute pancreatitis in Japan. Pancreas. 2014;43(8):1244–8. - PubMed
    1. Yadav D, O’connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Off J Am Coll Gastroenterol ACG. 2012;107(7):1096–103. - PubMed

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