%0 Journal Article
%T Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis-All of the Same?
%A Sirtl S
%A Bretthauer K
%A Ahmad M
%A Hohmann E
%A Schmidt VF
%A Allawadhi P
%A Vornhülz M
%A Klauss S
%A Goni E
%A Vielhauer J
%A Orgler E
%A Saka D
%A Knoblauch M
%A Hofmann FO
%A Schirra J
%A Schulz C
%A Beyer G
%A Mahajan UM
%A Mayerle J
%A Zorniak M
%J Pancreas
%V 53
%N 8
%D 2024 Sep 1
%M 38696426
%F 3.243
%R 10.1097/MPA.0000000000002349
%X <B>OBJECTIVE: </B>Severity of microlithiasis- and sludge-induced pancreatitis in comparison to gallstone-induced pancreatitis has never been studied for a lack of definition.<BR><B>METHODS: </B>In this retrospective cohort study, 263 patients with acute biliary pancreatitis treated at a tertiary care center from 2005 to 2021 were stratified according to the recent consensus definition for microlithiasis and sludge. The gallstone-pancreatitis cohort was compared to microlithiasis, sludge, and suspected stone passage pancreatitis cohorts in terms of pancreatitis outcome, liver function, and endosonography/endoscopic retrograde cholangiopancreatography results using one-way analysis of variance and χ 2 test. Multinomial logistic regression analysis was performed to correct for bias.<BR><B>RESULTS: </B>Microlithiasis- and sludge-induced pancreatitis, classified according to the revised Atlanta classification, did not present with a milder course than gallstone-induced pancreatitis ( P = 0.62). Microlithiasis and sludge showed an increase in bilirubin on the day of admission to hospital, which was not significantly different from gallstone-induced pancreatitis ( P = 0.36). The likelihood of detecting biliary disease on endosonography resulting in bile duct clearance was highest on the day of admission and day 1, respectively.<BR><B>CONCLUSIONS: </B>Microlithiasis and sludge induce gallstone-equivalent impaired liver function tests and induce pancreatitis with similar severity compared with gallstone-induced acute biliary pancreatitis.