Home|Journals|Articles by Year Follow on Twitter| Subscribe to List

Directory for Medical Articles
 

Open Access

Original Research



“PANCREATITIS SCREENING INDEX”, A NOVEL INDEX FOR IDENTIFYING GALL STONE PATIENTS AT RISK OF ACUTE PANCREATITIS? : AN OUTCOME OF A CASE CONTROL STUDY

Ankit Jain, Subhashish Das, Pawanindra Lal, NS Hadke, Jugal Kishore.

Abstract
Background: Acute pancreatitis is an inflammatory disease of pancreas that is associated with little or no fibrosis of the gland. Biliary tract disease account for 30-60% cases. Approximately 85% of patients with symptomatic gallstone mainly report biliary colicky pain whereas other patients may present with complications such as acute cholecystitis, acute pancreatitis, cholangitis etc. However, factors predisposing to pancreatitis over other complications of gall stones are not well known. We aim to identify potential factors which can predict the occurrence of pancreatitis in gall stone patients.
Material and Method: A single centre prospective Case Control study. 75 patients each of biliary pancreatitis (Group A) and of acute cholecystitis (group B) were enrolled in study. 6 weeks after acute attack they were assessed for gall bladder motility and taken up for cholecystectomy.
Results: Gallbladder motility was stronger in pancreatitis patients than in patients with acute cholecystitis (residual volume 12.85±1.18 vs 18.13±1.5, p = 0.000 and Ejection Fraction 57.5%%±2.17 vs 44.5%%±3.3, p = 0.000)). Pancreatitis patients more often had sludge (52% vs. 28%; p = 0.0027) and smaller (4.07±0.9mm vs 9.77± 1mm, p = 0.0000.) and more gallstones (32±8 vs 13±6, p = 0.008). Mean Pancreatitis Screening Index(PSI) [Ejection Fraction/ Size of Smallest Calculi] score for Group A was 0.24±0.1 whereas mean score for Group B was 0.063±0.01 (p value is 0.000). At PSI value ≥ 0.132, patients of AP were reliably distinguished from patients with acute cholecystitis (sensitivity=80%, specificity=94.5%).
Conclusion: Acute pancreatitis is more common in patients with smaller multiple stones with preserved gallbladder motility. Pancreatitis Screening Index can be a novel index to identify patients of gall stones at risk of acute pancreatitis. However, the potential benefit and usefulness of the index is yet to be elucidated.

Key words: Acute Pancreatitis; Acute Cholecystitis; Ellipsoid method; Ejection Fraction; Pancreatitis Screening Index



Share this Article


Advertisement
Oxidants and Antioxidants in Medical Science

SUBMIT YOUR ARTICLE NOW


ScopeMed.com
BiblioMed Home
Follow ScopeMed on Twitter
Author Tools
eJPort Journal Hosting
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
ScopeMed is a Database Service for Scientific Publications. Copyright © ScopeMed® Information Services.