Orkide KUTLU, Yılmaz BİLGİÇ, Bahri EVREN, Yahya ATAYAN, Yasir Furkan CAGİN

Alkolik Olmayan Yağlı Karaciğer Hastalığı Rekürren Akut Pankreatit için Bir Risk Faktörü müdür?

Amaç: Akut pankreatit (AP), pankreasın oto-digestif, inflamatuar bir hastalığı olup, hastaların dörtte bir kadarında rekürren akut pankreatit (RAP) ataklarıyla karşılaşılabilmektedir. Çalışmamızın amacı, RAP’li hastalarda alkolik olmayan yağlı karaciğer hastalığı (NAYKH) birlikteliğinin AP’li hastalardan farklı olup olmadığını incelemektir. Gereç ve Yöntem: 2014-2017’de AP öntanısıyla gastroenteroloji kliniğine yatırılmış hastalar retrospektif olarak tarandı. Atlanta kriterlerine göre AP tanısı konulan ve AP etiyolojisi alkol olmayan toplam 428 hasta çalışmaya dâhil edildi. Birden fazla atak geçiren 40 hasta RAP olarak tanımlandı. Hasta grupları yaş, hemoglobin, platelet, AST, ALT, ALP, GGT, total bilirübin, direkt bilirübin, kalsiyum, TG ölçümleri; kese operasyonu, ERCP işlem sayısı, karaciğer USG ve pankreas USG raporlarına göre istatistiksel olarak karşılaştırıldı. Bulgular: AP’li hastalarda grade I, II ve III yağlanma oranları sırasıyla %8, %10.8 ve %14.6 olup %66.6 hastada steatoz saptanmadı. RAP’li hastalarda grade I, II ve III yağlanma oranları ise sırasıyla %5, %12.5 ve %10 saptandı, %72.5 hastada steatoz saptanmadı. AP ile RAP grupları karşılaştırıldığında hepatobilier USG’de karaciğer yağlanması açısından istatistiksel açıdan anlamlı fark saptanmadı (p =0.761). Hastalarımızda RAP oranı %9.34 olarak bulundu. Her iki hasta grubu arasında değerlendirilen biyokimyasal parametreler içinde sadece TG değerleri RAP grubunda anlamlı yüksekti (p =0,002). Ayrıca RAP grubunda ERCP yapılan hastalar, anlamlı oranda yüksek saptandı (p =0,003). Sonuç: RAP’li hastalarda NAYKH sıklığı AP’li hastalar ile benzer saptandı. AP rekürrensleri etiyolojisinde NAYKH rolünü netleştirmek için bu alanda yapılacak yeni çalışmalara ihtiyaç olacaktır.

Is Nonalcoholic Fatty Liver Diease A Risk Factor for Recurrent Acute Pankreatitis?

Objective: Acute pancreatitis (AP) is an auto-digestive,inflammatory disease of the pancreas while recurrent episodes of acute pancreatitis can be seen in about a quarter of patients. The aim of this study was to investigate whether non- alcoholic fatty liver disease (NAFLD) association is different from AP patients in patients with recurrent acute pancreatitis (RAP). Material and Method: Patients who were admitted to gastroenterology clinic with the preliminary diagnosis of AP between 2014-2017 were screened retrospectively. A total of 428 patients with non-alcohol related AP, according to Atlanta criteria, were included in the study. Forty patients with multiple episodes were defined as RAP. Patient groups included age, gender, white blood cell, hemoglobulin, platelet, AST, ALT, ALP, GGT, total bilirubin, direct bilirubin, calcium, TG measurements; gall bladder operation, ERCP status, liver USG and pancreatic USG reports were compared statistically. Results: In patients with AP grade I, II and III rates of steatosis were 8%, 10.8% and 14.6% respectively; and in 66.6% steatosis was not detected. In patients with RAP, grade I, II and III rates were 5%, 12.5% and 10% respectively and in 72.5% steatosis was not detected. TG values (p =0.002) and ERCP status (p = 0,003) were significantly different in RAP group. There was no statistically significant difference for hepatosteatosis in hepatobiliary USG when AP and RAP groups were compared (p = 0.761). Conclusion: In our study, the prevalence of NAFLD in patients with RAP was similar to that in AP patients. In order to clarify the role of NAFLD in the etiology of AP recurrences, new studies will be needed.

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