| Objective:To analysis the clinical features,pathogenic factors and the efficacy of endoscopic management of recurrent acute pancreatitis(RAP),Evaluate the diagnostic and treatment value of endoscopic procedure in RAP.Methods:Patients with acute pancreatitis were enrolled from January2013 to October 2015 since ERCP availability in our hospital. Based on the results of follow-ups, the patients were divided into single attacked group and recurrent attacked group. The risk factors in each group and the efficacy of endoscopic management were analyzed.Results : 1042 patients were included, among all of the acute pancreatitis patients, single attacked group included 781 cases(74.95%),and in recurrent attacked group there were 261 cases(25.05%). The age and ratio of severe acute pancreatitis(SAP) between two groups were not significantly different(P> 0.05). The difference of gender(P=0.003) and ratio of pancreatic pseudocysts(P=0.039) between the two groups weresignificant. The recurrent rate of RAP was highest within the first half year after initial attack(127 cases, accounting for 48.66%) during the follow-up years. By logistic regression analysis: biliary factors(OR 1.812; 95%CI1.311~2.506), hyperlipidemia(OR 2.162; 95%CI 1.446~3.233) and pancreaticobiliary ductal abnormalities(OR 2.712; 95%CI 1.397~5.263)were the risk factors for recurrent AP. In RAP patients with unknown risk factors, 14 cases accepted endoscopic ultrasonography and 71.43%(10/14)of them were identified. 35 cases accepted ERCP and 82.85%(29/35) were identified. There were 58 patients with RAP underwent ERCP treatment with complete follow-ups, remission rate of endoscopic treatment was87.5%.Conclusions: Biliary factors, hyperlipidemia and pancreaticobiliary ductal abnormalities were the highest risk factors of RAP. Endoscopic management has great practical value for the diagnosis and treatment of RAP by significantly reducing the relapse rate of RAP. |
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