The Value Of Etiological Analysis And Endoscopic Treatment Of Recurrent Acute Pancreatitis

Objective: To investigate the clinical values of clinical features，pathogenic factors and endoscopic treatment of recurrent acute pancreatitis(RAP), so as to improve the level of diagnosis and treatment of RAP.Methods: The clinical data of234cases of RAP in-patient collectedfrom the First Affiliated Hospital of Chongqing Medical University duringDec.2004to Oct.2011was analyzed retrospectively. And, patients wereClassified into endoscopic treatment group (endoscopic group), surgicaltreatment group (surgical group) and medical treatment group (medicalgroup).Then, curative effects of each group were followed up. At last, acomparative analysis of recurrence among groups was made.Results: The main cause of RAP included biliary tract disease (93cases,39.8%), metabolic disease (60cases,25.6%) and alcohol abuse (46cases,19.6%). In234cases of RAP，the average recurrent frequency was1.4times.Recurrent interval from the initial onset was from3to96months, with theaverage recurrent interval of（22.5±18.8）months. There were193relapse cases within3years, with recurrent rate of82.5%. In endoscopic group andsurgical group，11cases（13.4%） and4cases（12.5%）got relapserespectively; comparing With both of their recurrence within three yearsbefore (endoscopic group:71cases, recurrence rate:86.6%; surgical group:26cases, recurrence rate:81.3%) the recurrence rates significantly decreased(P <0.01); In medical group,76patients (63.3%) got relapse, comparingWith its recurrence of96cases(80.0%) within three years before，the ratedecreased a little(P <0.05); Comparing with medical treatment, endoscopicand surgical treatment can reduce recurrence rate of RAP significantly (P <0.01).Conclusion: Biliary, metabolic and alcoholic RAP are the major typesof RAP. Endoscopy plays an important role in treatment RAP by greatlyreducing the recurrence rate.