Prognosis
The majority of patients with acute pancreatitis will improve within 3-7 days of conservative management. The cause of pancreatitis should be identified, and a plan to prevent recurrence should be initiated before the patient is discharged from hospital. In gallstone pancreatitis, a cholecystectomy should be performed before discharge in mild cases and a few months after the discharge date in patients with severe symptoms. In patients who are not candidates for surgery, endoscopic retrograde cholangiopancreatography must be considered. Long-term prognosis is based on the etiologic factor and patient compliance to lifestyle modifications.
In the absence of necrosis, acute pancreatitis generally resolves and leaves pancreatic function intact. In patients who do not respond within the first 72 hours, many will suffer from multiple organ failure. Death is most commonly associated with prolonged organ failure, with or without pancreatic necrosis. In patients with severe disease, prolonged hospitalization for many weeks or months is not uncommon.
In some patients, acute pancreatitis can become recurrent acute pancreatitis, often leading to chronic pancreatitis. More than one fifth of patients with acute pancreatitis experience recurrence after discharge.[117] The risk is higher among people who smoke, people with alcohol use disorder, and men.[118] Overall, episodes of acute pancreatitis associated with chronic pancreatitis are associated with lower mortality than episodes of acute pancreatitis without chronic pancreatitis.[119]
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