Usefulness of scheduled follow-up CT in discharged patients with acute pancreatitis

Abstract

Background and aim: Follow-up computed tomography (CT) in patients with acute pancreatitis has been advocated but rarely studied. The aim of this study was to determine whether follow-up CT for acute pancreatitis might be helpful in establishing the prognosis or complications, and in determining a selected subgroup of patients for whom computed tomography could be beneficial. Methods: Between January 2010 and December 2012, patients with acute pancreatitis who underwent follow-up CT in the outpatient department between one and three months after discharge were retrospectively enrolled. Events discovered on follow-up CT were defined as newly developed or increased pancreatic collection such as pseudocyst or walled off necrosis, and diagnosis of pancreatic cancer. Results: Ultimately, 106 asymptomatic patients were enrolled (mean age 50.24 +/- 16, 74.5% male, 31.1% moderately severe and severe acute pancreatitis). The median duration of follow-up CT was 69 (31-90) days. On follow-up CT, 23 patients showed events (2 pancreatic cancer, 21 increasing or developed pancreatic collections). In multivariate analysis, the predictive factors for events on follow-up CT were CTSI >= 3 (OR 4.46, CI 1.08-18.43, p = 0.039) and BISAP >= 2 (OR 4.83, CI 1.08-21.55, p = 0.039). Conclusions: Follow-up CT within three months after discharge may be helpful for acute pancreatitis patients with CTSI >= 3 points or BISAP score >= 2 points. Copyright (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.