Review of 10 years’ clinical experience of severe acute pancreatitis *
Between 1991 and 2000, 43 patients (28 men and 15 women) with severe acute pancreatitis based on the Japanese Ministry of Health and Welfare criteria were admitted to our hospital. These patients ranged in age from 22 to 86 years old (mean, 57 years old). The causes for severe acute pancreatitis in order of frequency were excessive alcohol consumption, biliary stones and idiopathic pancreatitis. Twenty-one patients were treated conservatively. The remainder underwent special treatment, including continuous regional arterial infusion of protease inhibitor and/or continuous hemofiltration. With the short-term prognosis, there were five deaths (four were alcoholic and one post-operative), resulting in a mortality rate of 12% (5/43 cases). With the long-term prognosis, 50% of the patients developed complications of some kind during the follow-up period. Patients whose biliary stones were not removed developed recurring pancreatitis with high frequency. Therefore, cholecystectomy or lithotripsy is strongly recommended for these patients. Alcoholic patients experienced after a recurrence of acute pancreatitis, and this worsened into chronic pancreatitis with high frequency. Two patients who continued to drink experienced recurring severe acute pancreatitis. For such patients, strict enforcement of abstinence from drinking is necessary. (Accepted on September 3, 2001) Kawasaki Igakkaishi 27(3) :201-208, 2001
