Acute alcoholic pancreatitis does not lead to complete recovery

The aim of the study was to determine the late outcome of acute alcoholic pancreatitis (a.a.p.), as assessed by clinical examination, functional tests and imaging techniques. 47 patients, 4-7 years after a.a.p. of moderate clinical course underwent a secretin-cerulein test (SCT), glucose tolerance test (GTT), ultrasound (US) and computed tomography (CT) of the pancreas. Exocrine pancreatic function impairment was found in 63.8%, glucose impaired tolerance (GIT)-in 12.8% overt diabetes-in 17.0%. GIT and overt diabetes were found only in patients with severe exocrine function impairment requiring enzyme supplementation. Ultrasound revealed pancreatic structure abnormalities mostly pancreas enlargement, pseudocysts, structural heterogeneity, contour irregularity, Wirsung duct dilatation and calcifications in 36.21% patients and computed tomography in 44.7%. Out of 16 patients with concomittant pathology found in SCT, US and CT 14 (29.8%) suffered from attacks of abdominal pain. We conclude that, as reflected by clinical symptoms, exo- and endocrine pancreatic function tests and imaging techniques, in about one third of patients even a moderate attack of a.a.p may lead to chronic pancreatitis. We suggest that patients after acute alcoholic pancreatitis should undergo prospective evaluation including both the function and structure estimation in order to early recognize and treat the revealed changes.