Abstract：
OBJECTIVE: The study aims to determine and quantify the stratified risk of recurrent pancreatitis (RP) after the first episode of acute pancreatitis in relation to etiology and severity of disease.
METHODS: A systematic review and meta-analysis in compliance with PRISMA statement standards was conducted. A search of electronic information sources was conducted to identify all studies investigating the risk of RP after the first episode of acute pancreatitis. Proportion meta-analysis models using random effects were constructed to calculate the weighted summary risks of RP. Meta-regression was performed to evaluate the effect of different variables on the pooled outcomes.
RESULTS: Analysis of 57,815 patients from 42 studies showed that the risk of RP after first episode was 19.8% (95% confidence interval [CI] 17.5-22.1%). The risk of RP was 11.9% (10.2-13.5%) after gallstone pancreatitis, 28.7% (23.5-33.9%) after alcohol-induced pancreatitis, 30.3% (15.5-45.0%) after hyperlipidemia-induced pancreatitis, 38.1% (28.9-47.3%) after autoimmune pancreatitis, 15.1% (11.6-18.6%) after idiopathic pancreatitis, 22.0% (16.9-27.1%) after mild pancreatitis, 23.9% (12.9-34.8%) after moderate pancreatitis, 21.6% (14.6-28.7%) after severe pancreatitis, and 6.6% (4.1-9.2%) after cholecystectomy following gallstone pancreatitis. Meta-regression confirmed that the results were not affected by the year of study (P = 0.541), sample size (P = 0.064), length of follow-up (P = 0.348), and age of patients (P = 0.138) in the included studies.
CONCLUSIONS: The risk of RP after the first episode of acute pancreatitis seems to be affected by the etiology of pancreatitis but not the severity of disease. The risks seem to be higher in patients with autoimmune pancreatitis, hyperlipidemia-induced pancreatitis, and alcohol-induced pancreatitis and lower in patients with gallstone pancreatitis and idiopathic pancreatitis.
METHODS: A systematic review and meta-analysis in compliance with PRISMA statement standards was conducted. A search of electronic information sources was conducted to identify all studies investigating the risk of RP after the first episode of acute pancreatitis. Proportion meta-analysis models using random effects were constructed to calculate the weighted summary risks of RP. Meta-regression was performed to evaluate the effect of different variables on the pooled outcomes.
RESULTS: Analysis of 57,815 patients from 42 studies showed that the risk of RP after first episode was 19.8% (95% confidence interval [CI] 17.5-22.1%). The risk of RP was 11.9% (10.2-13.5%) after gallstone pancreatitis, 28.7% (23.5-33.9%) after alcohol-induced pancreatitis, 30.3% (15.5-45.0%) after hyperlipidemia-induced pancreatitis, 38.1% (28.9-47.3%) after autoimmune pancreatitis, 15.1% (11.6-18.6%) after idiopathic pancreatitis, 22.0% (16.9-27.1%) after mild pancreatitis, 23.9% (12.9-34.8%) after moderate pancreatitis, 21.6% (14.6-28.7%) after severe pancreatitis, and 6.6% (4.1-9.2%) after cholecystectomy following gallstone pancreatitis. Meta-regression confirmed that the results were not affected by the year of study (P = 0.541), sample size (P = 0.064), length of follow-up (P = 0.348), and age of patients (P = 0.138) in the included studies.
CONCLUSIONS: The risk of RP after the first episode of acute pancreatitis seems to be affected by the etiology of pancreatitis but not the severity of disease. The risks seem to be higher in patients with autoimmune pancreatitis, hyperlipidemia-induced pancreatitis, and alcohol-induced pancreatitis and lower in patients with gallstone pancreatitis and idiopathic pancreatitis.
摘要：
目的：该研究旨在确定和量化急性胰腺炎首次发作后复发性胰腺炎（RP）的分层风险与病因和疾病严重程度的关系。
方法：进行符合PRISMA声明标准的系统评价和荟萃分析。对电子信息来源进行了搜索，以确定所有调查急性胰腺炎首次发作后RP风险的研究。构建了使用随机效应的比例荟萃分析模型来计算RP的加权汇总风险。进行元回归以评估不同变量对合并结果的影响。
结果：对42项研究中的57,815例患者的分析显示，首次发作后RP的风险为19.8％（95％置信区间[CI]17.5-22.1％）。胆石性胰腺炎后RP的风险为11.9%（10.2-13.5%），28.7%（23.5-33.9%）后酒精诱导的胰腺炎，高脂血症性胰腺炎后30.3%(15.5-45.0%),自身免疫性胰腺炎后38.1%（28.9-47.3%），特发性胰腺炎后15.1%（11.6-18.6%），轻度胰腺炎后22.0%（16.9-27.1%），中度胰腺炎后23.9%（12.9-34.8%），21.6％（14.6-28.7％）严重胰腺炎后，胆结石性胰腺炎后胆囊切除术后的6.6％（4.1-9.2％）。Meta回归证实，研究结果不受研究年份的影响（P=0.541）。样本量(P=0.064)，随访时间（P=0.348），纳入研究的患者年龄(P=0.138)。
结论：急性胰腺炎首次发作后发生RP的风险似乎受胰腺炎病因的影响，而不受疾病严重程度的影响。自身免疫性胰腺炎患者的风险似乎更高，高脂血症性胰腺炎,和酒精引起的胰腺炎，胆结石性胰腺炎和特发性胰腺炎患者较低。
方法：进行符合PRISMA声明标准的系统评价和荟萃分析。对电子信息来源进行了搜索，以确定所有调查急性胰腺炎首次发作后RP风险的研究。构建了使用随机效应的比例荟萃分析模型来计算RP的加权汇总风险。进行元回归以评估不同变量对合并结果的影响。
结果：对42项研究中的57,815例患者的分析显示，首次发作后RP的风险为19.8％（95％置信区间[CI]17.5-22.1％）。胆石性胰腺炎后RP的风险为11.9%（10.2-13.5%），28.7%（23.5-33.9%）后酒精诱导的胰腺炎，高脂血症性胰腺炎后30.3%(15.5-45.0%),自身免疫性胰腺炎后38.1%（28.9-47.3%），特发性胰腺炎后15.1%（11.6-18.6%），轻度胰腺炎后22.0%（16.9-27.1%），中度胰腺炎后23.9%（12.9-34.8%），21.6％（14.6-28.7％）严重胰腺炎后，胆结石性胰腺炎后胆囊切除术后的6.6％（4.1-9.2％）。Meta回归证实，研究结果不受研究年份的影响（P=0.541）。样本量(P=0.064)，随访时间（P=0.348），纳入研究的患者年龄(P=0.138)。
结论：急性胰腺炎首次发作后发生RP的风险似乎受胰腺炎病因的影响，而不受疾病严重程度的影响。自身免疫性胰腺炎患者的风险似乎更高，高脂血症性胰腺炎,和酒精引起的胰腺炎，胆结石性胰腺炎和特发性胰腺炎患者较低。
