Comparison of clinical characteristics of severe hyperlipidemic pancreatitis and severe acute gallstone pancreatitis

Abstract

Objective To compare the clinical characteristics and the outcomes of severe hyperlipidemic pancreatitis (SHLP) and severe acute gallstone pancreatitis (SAGP). Methods The clinical data of 22 patients with SHLP and 91 patients with SAGP admitted from January 2009 to December 2015 were retrospectively reviewed. The clinical manifestations, laboratory tests, organ dysfunction, medical treatment, complications and outcomes in 30 d after admission were analyzed and compared between two groups of patients. Results There were 16 males and 6 females with a mean age of (60.5±9.1) years in SHLP group; while 32 males and 59 females with a mean age of (54.3±5.4) years in SAGP group. The blood and urine amylase levels in SHLP group were significantly lower than those in SAGP group [(715±99) U/L vs. (1 551±107) U/L, t=4.65, P=0.00; (382±56) U/L vs. (773±66) U/L, t=4.52, P=0.00, respectively]. The incidence of circulation insufficiency, respiratory insufficiency, renal dysfunction, and long-term pulmonary infection in SHAP patients was significantly higher than that in SAGP patients [36%(8/22) vs.14%(13/91), χ2=5.22, P=0.01; 41%(9/22) vs.7%(6/91), χ2=9.46, P=0.01; 23%(51/22) vs.5%(5/91), χ2=4.20, P=0.03; 55%(12/22) vs. 32% (29/91), χ2=7.02, P=0.01]. Two cases died in the SHLP group and 9 cases died in SAGP group due to critical infection, cardiac events and bleeding. Conclusion Compared to SAGP patients, the blood and urine amylase levels are usually not remarkably high in SHLP patients, and the prevention and management of multi-organ failure and lung infection are more important for SHLP patients. Key words: Pancreatitis; Hyperlipidemias; Gallstones; alpha-Amylases