PREVALENCE, CLINICAL AND PARACLINICAL CHARACTERISTICS OF GALLSTONE-INDUCED ACUTE PANCREATITIS

Abstract

Objectives: This study aimed to investigate the clinical and paraclinical characteristics and severity of acute pancreatitis (AP) due to gallstones in comparison with other etiologies.

Methods: A cross-sectional study was conducted on 280 patients diagnosed with AP according to the 2012 Atlanta criteria and treated at Gia Dinh People's Hospital from April 2020 to April 2024. Data collected included demographics, clinical symptoms, biochemical tests, imaging findings, and disease severity. Comparisons were made between the group with gallstone-induced AP and those with other causes.

Results: The average age of the study population was 50.6 ± 17.2 years, with a male-to-female ratio of 2.5:1. Among the 280 patients, 62 cases (22.1%) were identified or suspected to be caused by gallstones. The gallstone AP group had a significantly higher proportion of females (48.4% vs. 22%, p <0.001), more frequent jaundice (22.6% vs. 2.8%,

p <0.001), and significantly higher levels of amylase, liver enzymes, bilirubin, and serum creatinine. The rates of organ failure in the gallstone group were also significantly higher: respiratory failure 14.5% vs. 5.5%, circulatory failure 11.3% vs. 3.7%, and acute kidney injury 12.9% vs. 4.6%. The proportion of patients with moderately severe or severe AP was 32.3% in the gallstone group compared to 16.1% in the non-gallstone group (p = 0.005).

Conclusions: Gallstone-induced AP presents with distinct clinical and paraclinical features and is associated with a higher rate of complications and organ failure. Early recognition of this group may assist in timely and appropriate clinical decision-making.

Keywords: acute pancreatitis; gallstones; organ failure; liver enzymes; clinical characteristics