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Gastroenterology Research and Practice
Volume 2017, Article ID 3525349, 7 pages
https://doi.org/10.1155/2017/3525349
Research Article

Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification

1Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
2Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
3Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence should be addressed to Supot Pongprasobchai; moc.liamg@gnoptopus

Received 25 September 2016; Revised 24 February 2017; Accepted 20 March 2017; Published 13 April 2017

Academic Editor: Atsushi Irisawa

Copyright © 2017 Supot Pongprasobchai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011–2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively. Two major types of initial intravenous fluid were normal saline (64%) and Ringer’s lactate solution (RLS, 28%). Enteral nutrition was given in 77% of patients with severe AP, median duration 48 hours, and via a nasogastric tube in 67% of patients. Necrotizing pancreatitis (NP) developed in 7% of patients, and 29% of them developed infection (median 17 days). The median length of stay was 6, 9, and 13 days, and the mortality rate was 1%, 3%, and 42% in mild, moderately severe, and severe AP, respectively. The overall mortality rate was 6%. Conclusion. The severity of AP in Thailand was mild, moderately severe, and severe in 72%, 16%, and 12% of patients, respectively. NP was not prevalent. Mortality was high in severe AP. Most treatments complied with standard guidelines except the underuse of RLS.