Clinical Medicine Insights: Geriatrics

Gabriel Sandblom¹, Tommy Bergman² and Ib Rasmussen³

¹Department of Surgery, University Hospital of Lund, Lund, Sweden. ²Department of Surgery, Södertälje Hospital, Södertälje, Sweden. ³Department of Surgery, University Hospital of Uppsala, Uppsala, Sweden.

Abstract

Objective: To explore the incidence and severity of pancreatitis and to assess the outcome of all measures taken to treat gallstones in following recovery from pancreatitis in patients 70 years of age or older in a community-based setting.

Methods:  All patients with pancreatitis as diagnosis in Uppsala, Sweden, 2003–2005, were identified retrospectively. Data relevant for assessing etiology and follow-up treatment were extracted from the patients’ histories. The electronic patient administrative system was crosschecked to determine mortality within 30 days after admission.

Result:  Altogether 148 admissions for 119 patients, including 48 men, were registered. On 29 occasions, admission was for relapse after a previous episode. Mortality within 30 days was 4/148 (2.7%). Twenty-two patients with gallstone induced acute pancreatitis underwent cholecystectomy and 27 patients underwent ERC with endoscopic sphincterotomy during follow-up. In a life table analysis, the probability of remaining relapse-free in the absence of cholecystectomy or endo- scopic sphincterotomy was estimated to 95% (95% confidence interval [CI] 91%–98%) two weeks after discharge and 92% (CI 88%–97%) eight weeks after discharge.

Conclusion:  Although pancreatitis in most cases is not a serious condition, it may become life threatening for elderly people. In patients with gallstone induced pancreatitis, accurate timing of cholecystectomy or endoscopic sphincterotomy in the follow-up period is crucial in order to preclude re-admissions for relapses.