Long-term outcome of severe acute pancreatitis

  • Takeo Yasuda
  • Takashi Ueda
  • Yoshifumi Takeyama
  • Makoto Shinzeki
  • Hidehiro Sawa
  • Takahiro Nakajima
  • Yoshikazu Kuroda
Original Article



This study was undertaken to evaluate the post-discharge outcome of severe acute pancreatitis (SAP) and to clarify the prognostic factors for poor outcome.


In 45 patients, recurrence of acute pancreatitis (AP), transition to chronic pancreatitis (CP), and development of diabetes mellitus (DM) were evaluated. Relationships of the outcome with the findings on admission and the presence/absence of alcohol intake were analyzed.


The mean follow-up period was 56 ± 6 months. Recurrence of AP was noted in 19% of the patients. The recurrence rate was higher in patients with necrotizing pancreatitis than in those without this feature. C-reactive protein and white blood cell (WBC) count were higher in patients with recurrence of AP. Transition to CP was noted in 22% of patients. The transition rate was higher in those with alcoholic SAP than in those with biliary SAP. In patients with transition to CP, the WBC count, hematocrit, Ranson score, and Japanese severity score were higher, and base excess (BE) was lower, compared with these features in patients without this transition. Development of DM was noted in 39% of patients. Blood glucose and BE were higher in patients who developed DM than in those who did not.


The degree of inflammation and pancreatic necrosis found on admission for SAP may be related to the recurrence of AP. Alcoholic SAP in which the disease is very severe may contribute to the transition to CP. Patients with impaired glucose tolerance readily develop DM after SAP.

Key words

Severe acute pancreatitis Long-term outcome Recurrence Chronic pancreatitis Diabetes mellitus 


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Copyright information

© Springer Japan 2008

Authors and Affiliations

  • Takeo Yasuda
    • 1
  • Takashi Ueda
    • 1
  • Yoshifumi Takeyama
    • 2
  • Makoto Shinzeki
    • 1
  • Hidehiro Sawa
    • 1
  • Takahiro Nakajima
    • 1
  • Yoshikazu Kuroda
    • 1
  1. 1.Department of Gastroenterological SurgeryKobe University Graduate School of Medical SciencesKobeJapan
  2. 2.Department of SurgeryKinki University School of MedicineOsaka-sayamaJapan

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