A systematic review of the predictive factors for the recurrence of acute pancreatitis

Abstract Purpose Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, w...

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Main Authors: Daniela Pacella, Adriano De Simone, Adolfo Pisanu, Gianluca Pellino, Lucio Selvaggi, Valentina Murzi, Eleonora Locci, Giulia Ciabatti, Laura Mastrangelo, Elio Jovine, Matteo Rottoli, Giacomo Calini, Stefano Cardelli, Fausto Catena, Carlo Vallicelli, Raffaele Bova, Gabriele Vigutto, Fabrizio D’Acapito, Giorgio Ercolani, Leonardo Solaini, Alan Biloslavo, Paola Germani, Camilla Colutta, Pasquale Lepiane, Rosa Scaramuzzo, Savino Occhionorelli, Domenico Lacavalla, Maria Grazia Sibilla, Stefano Olmi, Matteo Uccelli, Alberto Oldani, Alessio Giordano, Tommaso Guagni, Davina Perini, Francesco Pata, Bruno Nardo, Daniele Paglione, Giusi Franco, Matteo Donadon, Marcello Di Martino, Salomone Di Saverio, Luca Cardinali, Grazia Travaglini, Dario Bruzzese, Mauro Podda
Format: Article
Language:English
Published: BMC 2025-04-01
Series:World Journal of Emergency Surgery
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Online Access:https://doi.org/10.1186/s13017-025-00601-x
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author Daniela Pacella
Adriano De Simone
Adolfo Pisanu
Gianluca Pellino
Lucio Selvaggi
Valentina Murzi
Eleonora Locci
Giulia Ciabatti
Laura Mastrangelo
Elio Jovine
Matteo Rottoli
Giacomo Calini
Stefano Cardelli
Fausto Catena
Carlo Vallicelli
Raffaele Bova
Gabriele Vigutto
Fabrizio D’Acapito
Giorgio Ercolani
Leonardo Solaini
Alan Biloslavo
Paola Germani
Camilla Colutta
Pasquale Lepiane
Rosa Scaramuzzo
Savino Occhionorelli
Domenico Lacavalla
Maria Grazia Sibilla
Stefano Olmi
Matteo Uccelli
Alberto Oldani
Alessio Giordano
Tommaso Guagni
Davina Perini
Francesco Pata
Bruno Nardo
Daniele Paglione
Giusi Franco
Matteo Donadon
Marcello Di Martino
Salomone Di Saverio
Luca Cardinali
Grazia Travaglini
Dario Bruzzese
Mauro Podda
author_facet Daniela Pacella
Adriano De Simone
Adolfo Pisanu
Gianluca Pellino
Lucio Selvaggi
Valentina Murzi
Eleonora Locci
Giulia Ciabatti
Laura Mastrangelo
Elio Jovine
Matteo Rottoli
Giacomo Calini
Stefano Cardelli
Fausto Catena
Carlo Vallicelli
Raffaele Bova
Gabriele Vigutto
Fabrizio D’Acapito
Giorgio Ercolani
Leonardo Solaini
Alan Biloslavo
Paola Germani
Camilla Colutta
Pasquale Lepiane
Rosa Scaramuzzo
Savino Occhionorelli
Domenico Lacavalla
Maria Grazia Sibilla
Stefano Olmi
Matteo Uccelli
Alberto Oldani
Alessio Giordano
Tommaso Guagni
Davina Perini
Francesco Pata
Bruno Nardo
Daniele Paglione
Giusi Franco
Matteo Donadon
Marcello Di Martino
Salomone Di Saverio
Luca Cardinali
Grazia Travaglini
Dario Bruzzese
Mauro Podda
author_sort Daniela Pacella
collection DOAJ
description Abstract Purpose Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease. Methods A systematic review was conducted selecting studies from BiomedCentral, PubMed, Scopus and Web of Science by two independent reviewers. Publications were considered only if written in English in the time interval between January 2000 and June 2024 and investigated the risk factors for the recurrence of BAP and AAP. At the end of the selection, a quality assessment phase was conducted using the PROBAST tool. Results In this systematic review, 8 articles were selected out of 6.945, involving a total sample of 11.271 patients of which 38.77% developed recurrence episodes. 37.5% of the included studies focus on recurrent acute biliary pancreatitis (RBAP), while 62.5% are dedicated to recurrent acute alcoholic pancreatitis (RAAP). The risk factors for the recurrence of AP showed a clear differentiation between the alcoholic and biliary etiology. Most of the considered studies adopted a retrospective design, characterized by a susceptibility to potential methodological biases. However, the trend indicated a more recent increase in prospective studies, together with a greater focus on identifying and understanding the possible risk factors associated with the recurrence of acute pancreatitis (RAP). This result highlighted the progress in the scientific approach toward a more rigorous and systematic assessment of the causes and dynamics that influence the recurrence of the disease. Conclusion Studies highlighted the importance of lifestyle factors, clinical complications, and surgical interventions that can impact the risk of biliary or alcoholic recurrent acute pancreatitis. Increased and systematic adoption of artificial intelligence-based tools could significantly impact future knowledge relating to the risks of recurrence and relative possibilities of prevention.
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spelling doaj-art-05e8fda86de44ae7a60b97d2ee60b8172025-08-20T03:10:11ZengBMCWorld Journal of Emergency Surgery1749-79222025-04-0120111310.1186/s13017-025-00601-xA systematic review of the predictive factors for the recurrence of acute pancreatitisDaniela Pacella0Adriano De Simone1Adolfo Pisanu2Gianluca Pellino3Lucio Selvaggi4Valentina Murzi5Eleonora Locci6Giulia Ciabatti7Laura Mastrangelo8Elio Jovine9Matteo Rottoli10Giacomo Calini11Stefano Cardelli12Fausto Catena13Carlo Vallicelli14Raffaele Bova15Gabriele Vigutto16Fabrizio D’Acapito17Giorgio Ercolani18Leonardo Solaini19Alan Biloslavo20Paola Germani21Camilla Colutta22Pasquale Lepiane23Rosa Scaramuzzo24Savino Occhionorelli25Domenico Lacavalla26Maria Grazia Sibilla27Stefano Olmi28Matteo Uccelli29Alberto Oldani30Alessio Giordano31Tommaso Guagni32Davina Perini33Francesco Pata34Bruno Nardo35Daniele Paglione36Giusi Franco37Matteo Donadon38Marcello Di Martino39Salomone Di Saverio40Luca Cardinali41Grazia Travaglini42Dario Bruzzese43Mauro Podda44Department of Public Health, University of Naples Federico IIDepartment of Public Health, University of Naples Federico IIEmergency Surgery Unit, Department of Surgical Science, University of CagliariDepartment of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”Emergency Surgery Unit, Department of Surgical Science, University of CagliariEmergency Surgery Unit, Department of Surgical Science, University of CagliariDepartment of Medical and Surgical Science, University of Bologna, Maggiore HospitalDepartment of Medical and Surgical Science, University of Bologna, Maggiore HospitalDepartment of Medical and Surgical Science, University of Bologna, Maggiore HospitalDepartment of Medical and Surgical Science, University of Bologna, Sant’Orsola HospitalDepartment of Medical and Surgical Science, University of Bologna, Sant’Orsola HospitalDepartment of Medical and Surgical Science, University of Bologna, Sant’Orsola HospitalDepartment of General, Emergency and Trauma Surgery, Bufalini HospitalDepartment of General, Emergency and Trauma Surgery, Bufalini HospitalDepartment of General, Emergency and Trauma Surgery, Bufalini HospitalDepartment of General, Emergency and Trauma Surgery, Bufalini HospitalDepartment of Medical and Surgical Science, University of Bologna, Morgagni-Pierantoni Hospital ForlìDepartment of Medical and Surgical Science, University of Bologna, Morgagni-Pierantoni Hospital ForlìDepartment of Medical and Surgical Science, University of Bologna, Morgagni-Pierantoni Hospital ForlìDepartment of General Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, University of TriesteDepartment of General Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, University of TriesteDepartment of General Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, University of TriesteDepartment of Surgery, San Paolo Hospital CivitavecchiaDepartment of Surgery, San Paolo Hospital CivitavecchiaDepartment of Morphology, Surgery and Experimental Medicine, University of FerraraDepartment of Morphology, Surgery and Experimental Medicine, University of FerraraDepartment of Morphology, Surgery and Experimental Medicine, University of FerraraDepartment of General Surgery, San Donato Hospital ZingoniaDepartment of General Surgery, San Donato Hospital ZingoniaDepartment of General Surgery, San Donato Hospital ZingoniaDepartment of Emergency Surgery, Careggi HospitalDepartment of Emergency Surgery, Careggi HospitalDepartment of Emergency Surgery, Careggi HospitalDepartment of Pharmacy, Health and Nutritional Sciences, University of CalabriaDepartment of Pharmacy, Health and Nutritional Sciences, University of CalabriaDepartment of Pharmacy, Health and Nutritional Sciences, University of CalabriaDepartment of Pharmacy, Health and Nutritional Sciences, University of CalabriaDepartment of Health Science, University of Piemonte Orientale, Ospedale Maggiore della CaritàDepartment of Health Science, University of Piemonte Orientale, Ospedale Maggiore della CaritàDepartment of Surgery, Madonna del Soccorso HospitalDepartment of Surgery, Madonna del Soccorso HospitalDepartment of Surgery, Madonna del Soccorso HospitalDepartment of Public Health, University of Naples Federico IIEmergency Surgery Unit, Department of Surgical Science, University of CagliariAbstract Purpose Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease. Methods A systematic review was conducted selecting studies from BiomedCentral, PubMed, Scopus and Web of Science by two independent reviewers. Publications were considered only if written in English in the time interval between January 2000 and June 2024 and investigated the risk factors for the recurrence of BAP and AAP. At the end of the selection, a quality assessment phase was conducted using the PROBAST tool. Results In this systematic review, 8 articles were selected out of 6.945, involving a total sample of 11.271 patients of which 38.77% developed recurrence episodes. 37.5% of the included studies focus on recurrent acute biliary pancreatitis (RBAP), while 62.5% are dedicated to recurrent acute alcoholic pancreatitis (RAAP). The risk factors for the recurrence of AP showed a clear differentiation between the alcoholic and biliary etiology. Most of the considered studies adopted a retrospective design, characterized by a susceptibility to potential methodological biases. However, the trend indicated a more recent increase in prospective studies, together with a greater focus on identifying and understanding the possible risk factors associated with the recurrence of acute pancreatitis (RAP). This result highlighted the progress in the scientific approach toward a more rigorous and systematic assessment of the causes and dynamics that influence the recurrence of the disease. Conclusion Studies highlighted the importance of lifestyle factors, clinical complications, and surgical interventions that can impact the risk of biliary or alcoholic recurrent acute pancreatitis. Increased and systematic adoption of artificial intelligence-based tools could significantly impact future knowledge relating to the risks of recurrence and relative possibilities of prevention.https://doi.org/10.1186/s13017-025-00601-xRisk factorsAcute PancreatitisRecurrenceBiliaryAlcoholic
spellingShingle Daniela Pacella
Adriano De Simone
Adolfo Pisanu
Gianluca Pellino
Lucio Selvaggi
Valentina Murzi
Eleonora Locci
Giulia Ciabatti
Laura Mastrangelo
Elio Jovine
Matteo Rottoli
Giacomo Calini
Stefano Cardelli
Fausto Catena
Carlo Vallicelli
Raffaele Bova
Gabriele Vigutto
Fabrizio D’Acapito
Giorgio Ercolani
Leonardo Solaini
Alan Biloslavo
Paola Germani
Camilla Colutta
Pasquale Lepiane
Rosa Scaramuzzo
Savino Occhionorelli
Domenico Lacavalla
Maria Grazia Sibilla
Stefano Olmi
Matteo Uccelli
Alberto Oldani
Alessio Giordano
Tommaso Guagni
Davina Perini
Francesco Pata
Bruno Nardo
Daniele Paglione
Giusi Franco
Matteo Donadon
Marcello Di Martino
Salomone Di Saverio
Luca Cardinali
Grazia Travaglini
Dario Bruzzese
Mauro Podda
A systematic review of the predictive factors for the recurrence of acute pancreatitis
World Journal of Emergency Surgery
Risk factors
Acute Pancreatitis
Recurrence
Biliary
Alcoholic
title A systematic review of the predictive factors for the recurrence of acute pancreatitis
title_full A systematic review of the predictive factors for the recurrence of acute pancreatitis
title_fullStr A systematic review of the predictive factors for the recurrence of acute pancreatitis
title_full_unstemmed A systematic review of the predictive factors for the recurrence of acute pancreatitis
title_short A systematic review of the predictive factors for the recurrence of acute pancreatitis
title_sort systematic review of the predictive factors for the recurrence of acute pancreatitis
topic Risk factors
Acute Pancreatitis
Recurrence
Biliary
Alcoholic
url https://doi.org/10.1186/s13017-025-00601-x
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