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Increase in acute pancreatitis, especially gallstone related, as the cause for emergency admissions: Temporal trend from Kashmir, India

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Abstract

Background

The incidence of acute pancreatitis is increasing globally. Gallstones (GS) and ascariasis are the major causes for acute pancreatitis in the Kashmiri population. In recent years, we have observed an increase in the admission rate of acute pancreatitis. Many patients who present first time as gallstone pancreatitis have asymptomatic gallstones. We aimed at studying the etiology and yearly admission rate of acute pancreatitis with main focus on gallstone pancreatitis and the contribution of asymptomatic gallstones.

Methods

This was a hospital-based, prospective, observational study from January 2015 to December 2019 for a period of five years. Patients of acute pancreatitis were evaluated for etiology and yearly admission rate. Patients of gallstone pancreatitis were evaluated in terms of clinical profile, risk factors, nature (symptomatic/asymptomatic, known/unknown gallstones), size of stones, treatment and outcome in terms of severity and mortality. The data was analyzed by Statistical Package for the Social Sciences (SPSS) version 20.0, as mean (SD), frequencies and percentages.

Results

As many as 702 (8.5%) patients of acute pancreatitis were admitted among 8245 gastrointestinal emergencies in five years. The yearly admission rate of acute pancreatitis was 5.6%, 7.3%, 8.7%, 9.5% and 10.3%, respectively (p = 0.013). Gallstones, Ascariasis, alcohol and idiopathic acute pancreatitis were 47.7%, 6.9%, 1.2% and 33.7%, respectively. Gallstone pancreatitis increased from 31% in 2015 to 52.4% in 2019 (p = 0.045) and ascariasis-related acute pancreatitis declined from 14.4% to 1.6% (p = 0.034). Asymptomatic gallstones constituted 87.7% of cases. Known/unknown asymptomatic gallstones and symptomatic gallstones were 24.4%, 63.2% and 12.2%, respectively. Gallstones < 5 mm and > 5 mm were76.1% and 23.8% respectively (p = 0.027). Cholecystectomy rate in index admission was 4.7%. Mild, moderate and severe gallstone pancreatitis was 60.2%, 18.8% and 20.8%, respectively. Mortality in gallstone pancreatitis was 10.4%.

Conclusion

The incidence of acute pancreatitis is increasing due to gallstone pancreatitis. Ascariasis-related acute pancreatitis has declined. There is significant contribution of asymptomatic gallstones in patients who present for the first time as acute pancreatitis. Small gallstones < 5 mm are likely to be the risk factors for gallstone pancreatitis.

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Authors and Affiliations

  1. Department of Gastroenterology, Sheri-I-Kashmir Institute of Medical Sciences, Srinagar, 190 011, India

    Shaheena Parveen, Jaswinder Singh Sodhi, Shaheen Nazir, Ankush Sharma, Tariq Abdullah Mir, Kalpana Acharya, Mushtaq Ahmed Khan, Ghulam Mohd Gulzar & Altaf Hussain Shah

  2. Department of Gastroenterology and Hepatology, Sarvodya Hospital, Faridabad, 121 006, India

    Neeraj Dhar

  3. Department of Gastroenterology, Thumbay Hospital, Dubai, UAE

    Ghulam Nabi Yattoo

  4. Department of Radiation Oncology, Sheri-I-Kashmir Institute of Medical Sciences, Srinagar, 190 011, India

    Kuldeep S. Raina

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  1. Shaheena Parveen
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Contributions

Concept and design of study: Jaswinder Singh Sodhi, Shaheena Parveen, Neeraj Dhar; data collection, analysis, interpretation, manuscript drafting; Neeraj Dhar, Shaheen Nazir, Ankush Sharma, Kalpana Acharya, Shaheena Parveen, Jaswinder Singh Sodhi; review and revision of manuscript and critical analysis of data; Jaswinder Singh Sodhi, Altaf Husain Shah, Mushtaq Ahmed Khan, Ghulam Mohd Gulzar, Ghulam Nabi Yattoo; statistical analysis of data; Kuldeep Singh Raina. All authors read and approved the manuscript.

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Correspondence to Jaswinder Singh Sodhi.

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Conflict of interest

SP, JSS, ND, SN, AS, TAM, KA, MAK, GMG, AHS, GNY and KSR  declare no competing interests.

Ethics statement

The study was performed conforming to the Helsinki Declaration of 1975 as revised in 2000 and 2008, concerning human and animal rights and the authors followed the policy concerning informed consent as shown on Springer.com.

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Ethical approval was obtained by the institutional ethics committee (IEC, SKIMS, and RP52) and informed consent was taken in each patient.

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Parveen, S., Singh Sodhi, J., Dhar, N. et al. Increase in acute pancreatitis, especially gallstone related, as the cause for emergency admissions: Temporal trend from Kashmir, India. Indian J Gastroenterol (2024). https://doi.org/10.1007/s12664-023-01509-7

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