Continuing episodes of pain in recurrent acute pancreatitis: Prospective follow up on a standardised protocol with drugs and pancreatic endotherapy

Pai, Ganesh C and Kamath, Ganesh M and Shetty, Mamatha V and Kurien, Annamma (2017) Continuing episodes of pain in recurrent acute pancreatitis: Prospective follow up on a standardised protocol with drugs and pancreatic endotherapy. World Journal of Gastroenterology, 23 (19). pp. 3538-3545. ISSN 1007-9327

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Abstract

Aim To assess the outcomes of drug therapy (DT) followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis. Methods: DT comprised of pancreatic enzymes and antioxidants failing which, endotherapy (ET; pancreatic sphincterotomy and stent placement) was done. The frequency of pain, its visual analogue score (VAS), quality of life (QoL), serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET. Response was defined as at least 50% reduction in the severity of pain to below a score of 5. Results: Of the thirty nine patients analysed, 21 (53.9%) responded to DT and 18 (46.1%) underwent ET. The VAS for pain (7.0 ± 2.0 vs 1.3 ± 2.5, P < 0.001) and the number of days with pain per month decreased [1.0 (1.0, 2.0) vs 1.0 (0.0, 1.0), P < 0.001], and the QoL scores [55.0 (44.0, 66.0) vs 38.0 (32.00, 51.00), P < 0.01] improved significantly during follow up. Similar significant improvements were seen in patients in the subgroups of DT and ET except for QoL in ET. The serum C-peptide (P = 0.001) and FE (P < 0.001) levels improved significantly in the entire group and in the two subgroups of patients except for the C peptide levels in patients on DT. Conclusion: A standardised protocol of DT, followed by ET decreased the intensity and frequency of pain in recurrent acute pancreatitis, enhanced QoL and improved pancreatic function.

Item Type: Article
Uncontrolled Keywords: Drug therapy, Endoscopy, Exocrine insufficiency, Pancreatic diabetes, Pancreatic duct stents, Quality of life, Recurrent acute pancreatitis, Surgery.
Subjects: Medicine > KMC Manipal > Gastroenterology
Medicine > MMMC Manipal > Pathology
Medicine > MMMC Manipal > Physiology
Depositing User: KMC Library
Date Deposited: 05 Jun 2017 10:55
Last Modified: 05 Jun 2017 10:55
URI: http://eprints.manipal.edu/id/eprint/148992

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