Clinical Analysis Of The Mild Acute Pancreatitis Accompanied With Acute Liver Damage

Objective:To investigate the clinical characters, possible causes and prognosis of acute liver damage in patients with mild acute pancreatitis.Methods:The clinical data of186cases of mild acute pancreatitis patients treated in the Department of Gastroenterology of our hospital from January2009-March2012were retrospectively analyzed. Group the patients according to the etiology of mild acute pancreatitis, age and gender respectively, and compare the incidence, severity, characters of abnormal indicators and prognosis of the acute liver damage. Explore the relationship between the acute liver damage and some clinical indicators of mild acute pancreatitis. Analysis the acute liver damage’s influence to the prognosis of mild acute pancreatitis according to the days of hospitalization, abdominal pain recovery time and serum amylase recovery time.Results:There are122cases with acute liver dysfunction in the186cases of mild acute pancreatitis, accounting for65.6%,and in the122mild acute pancreatitis with acute liver damage biliary pancreatitis accounted for65.6%. The incidence of acute liver damage of different causes of mild acute pancreatitis is failure the same(P<0.05), but the incidence of acute liver damage of the biliary and Alcoholic mild acute pancreatitis was no significant difference (P>0.017); the incidence of acute liver damage in old age group (≥60years old) is higher than the middle age group (45～59years old) and youth group (<45years old)(P<0.017, P<0.017), while the incidence of acute liver injury in patients with mild acute pancreatitis for men and women have no difference (P>0.05). Overall, abnormalities both in transaminase and bilirubin commonly occur in the mild acute pancreatitis with acute liver dysfunction. Compare the biliary mild acute pancreatitis and non-biliary mild acute pancreatitis, the former prone to elevated transaminase or accompanied by elevated bilirubin, and the latter is more common pure bilirubin increased, what’s more, The severity of the acute liver injury is heavier in the former than in the latter (P<0.05). The serum amylase level at24hours of onset, the proportion of the presence of peritoneal irritation when admitted to hospital and blood glucose abnormal ratio are higher in mild acute pancreatitis associated with acute liver damage, compared with the ones not associated with acute liver damage in the same period (P<0.05, P<0.05, P<0.05). As to the prognosis, liver damage can extend the period of hospital stay, recovery time of abdominal pain and recovery time of serum amylase in the mild acute pancreatitis (P<0.05), but the outcomes of the liver injury itself are good.Conclusions:Complicated by acute liver dysfunction is common in the clinical course of the mild acute pancreatitis patients, and at the same time the characteristics and severity of the liver injury in different causes of mild acute pancreatitis are different. Liver damage will extend the course of mild acute pancreatitis to a certain extent, but the outcomes of the liver injury itself are good. The occurrence of acute liver damage is closely related to a variety of disruptive factor in the pathogenesis of acute pancreatitis, particularly biliary obstruction or inflammation. As to the treatment, in addition to aggressive treatment of acute pancreatitis, hepatoprotective treatment is also sometimes needed, what’s more, close observation of the liver function is necessary. The mild acute pancreatitis with acute liver damage should be paid more attention.