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Is acute necrotising pancreatitis a chronic disease?
  1. Deepak Gunjan,
  2. Soumya Jagannath Mahapatra,
  3. Pramod Kumar Garg
  1. Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Pramod Kumar Garg, Gastroenterology, All India Institute of Medical Sciences, New Delhi, Delhi 110029, India; pgarg{at}aiims.edu

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Acute pancreatitis (AP) is a common disease with an annual incidence of 34 (23–49) per 100 000 population.1 Patients with acute interstitial pancreatitis have a shorter self-limiting disease course while acute necrotising pancreatitis (ANP) is a much more severe disease with major local and systemic complications mandating prolonged hospitalisation.2 Among the local complications, acute necrotic fluid collections and walled-off necrosis require interventions preferably minimally invasively such as percutaneous and per-oral endoscopic drainage, and necrosectomy.3 Although the majority of patients survive the illness but their misery doesn't end there with potential long-term serious consequences. This is the focus of the cohort study comprising of 373 patients with a median follow-up of 13.5 years published in Gut by Hollemans et al. 4

The word ‘chronic’ literally refers to disease duration. The Centers for Disease Control (CDC) define chronic diseases broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.5 WHO defines Long COVID as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection.6 It is in this context that we will discuss the study by the Dutch Pancreatitis Study group.

The long-term complications of ANP could either be related to the aetiology of the index episode of AP or the local complications that develop following AP. These complications include recurrent and chronic pancreatitis (CP), persistent or recurrent fluid collections, pancreatico-cutaneous fistula, biliary and gastric outlet obstructions, and vascular complications such as pseudoaneurysm. In addition, functional consequences develop due to loss of pancreatic parenchyma comprising of both exocrine and endocrine components. Among patients with ANP, …

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Footnotes

  • Contributors DG, SJM and PKG conceptualised, wrote and approved the commentary.

  • Funding PKG is supported by a ‘Centre for Advanced Research and Excellence in Pancreatic Diseases’ grant from the Indian Council of Medical Research (Grant number Coord/7(9)/CARE-PD/18-NCD-II) and JC Bose Fellowship by the Science & Engineering Board, India (Grant number JCB/2020/000029).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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