Morphological and functional consequences and quality of life following severe acute pancreatitis

Abstract

In this study, we evaluated pancreatic morphology and function as well as nutritional status and quality of life among patients who experienced severe acute pancreatitis (SAP).

MATERIALS AND METHODS: We enrolled 99 patients with SAP and 51 with mild acute pancreatitis (MAP). Computed tomography was performed one year following the disease. Endocrine function was evaluated by measuring hemoglobin A1c, insulin, and C peptide levels. Pancreatic exocrine insufficiency (PEI) was diagnosed by the concentration of fecal elastase-1. Nutritional status was assessed according to anthropometric parameters, albumin levels in blood serum, and the total number of lymphocytes. Quality of life was investigated using the Health Survey Questionnaire (SF-36).

RESULTS: PEI was observed in 17.2% of patients after SAP vs. 7.8% of patients after MAP (p>0.05). Endocrine insufficiency was noted in 18.6% of patients after AP vs. 4.3% of patients after MAP (p<0.05). We observed changes in pancreatic morphology in 52.5% of patients after SAP and 9.8% of patients after MAP (p<0.0001). A medium risk of malnutrition was observed in 16.2% of patients after AP vs. 2% of patients after MAP (p=0.01). Patients with SAP described their mental health in more negative terms than patients with MAP (p<0.05).

CONCLUSIONS: One year after SAP, patients exhibited changes in pancreatic morphology and carbohydrate metabolism disorders, and exocrine insufficiency occurred with a similar frequency. The majority of quality of life domains did not differ between patient groups.