Page 90 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

highlighted to favor carcinogenesis and might be associated the prediction of severity and contribute to a more
with the incidence of HCC in the DAA treated SVR group. individualized patient care.
Aims: This study aimed to investigate the role of diabetes
mellitus (DM), as a potential predictive risk factor, in the 148. ALREADY EXISTING PSEUDOCYSTS IN ACUTE
development of HCC in HCV-infected patients after DAA PANCREATITIS CAN BE AN EARLY MARKER OF
treatment. CHRONIC PANCREATITIS - ANALYSIS OF 1270 CASES
Methods: We performed a systematic search in three FROM A PROSPECTIVE COHORT
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medical databases. Studies were eligible if they reported on Vörhendi N. , Tinusz B. , Gede N. , Vincze A. , Takács T. ,
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HCV-infected patients with SVR who had at least one year of Czakó L. , Izbéki F. , Gajdán L. , Dunás-Varga V. , Hamvas
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follow-up after DAA treatment, and reported the frequency of J. , Papp M. , Fehér K. , Varga M. , Mickevicius A. , Török
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incident and/or recurrent HCC in patients with and without I. , Ocskay K. , Juhász F. , Váncsa S. , Faluhelyi N. ,
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DM. We calculated pooled hazard ratios (HR) with 95% Farkas O. , Miseta A. , Vereczkei A. , Mikó A. , Hegyi P. ,
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12
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confidence intervals (CIs) in meta-analysis. Szentesi A. , Párniczky A. , Erőss B. , Hegyi P. 1,3,15
Results: Fourteen cohort studies were included. DM proved 1. Institute for Translational Medicine, Medical School,
to be a significant risk factor of HCC in HCV patients in University of Pécs, Pécs, Hungary; 2. Division of
univariate analysis (HR=1.52, CI=1.18-1.95), which Gastroenterology, First Department of Medicine, Medical
association was less prominent but significant after School, University of Pécs, Pécs, Hungary; 3. First
adjustment for covariates (HR=1.29, CI=1.01-1.63). In the Department of Medicine, University of Szeged, Szeged,
subgroup of liver cirrhosis, the point estimate was similar but Hungary; 4. Szent György University Teaching Hospital of
non-significant (HR=1.54, CI=0.91-2.62). Besides, DM was Fejér County, Székesfehérvár, Hungary; 5. Peterfy Hospital,
not a significant predictor of HCC recurrence (HR=1.27, Budapest, Hungary; 6. Department of Internal Medicine,
CI=0.79-2.05). Division of Gastroenterology, University of Debrecen,
Conclusion: DM seems to be an independent risk factor of Debrecen, Hungary; 7. County Emergency Clinical Hospital
developing HCC after DAA treatment in HCV-infected - Gastroenterology and University of Medicine, Pharmacy,
patients; therefore, we suggest a more rigorous follow-up in Sciences and Technology, Targu Mures, Romania; 8. Vilnius
this group. University Hospital Santaros Clinics, Vilnius, Lithuania
Clinics of Abdominal Surgery, Nephrourology and
147. FATTY LIVER DISEASE WORSENS THE OUTCOME Gastroenterology, Faculty of Medicine, Vilnius University,
IN ACUTE PANCREATITIS: A SYSTEMATIC REVIEW Vilnius, Lithuania; 9. Heim Pál National Institute of Pediatrics;
AND META-ANALYSIS 10. Department of Radiology, Medical School, University of
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Váncsa S. , Németh D. , Hegyi P. , Szakács Z. , Hegyi J. , Pécs, Pécs, Hungary; 11. Department of Laboratory
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Pécsi D. , Mikó A. , Erőss B. , Erős A. , Pár G. Medicine, Medical School, University of Pécs, Pécs,
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1. Institute for Translational Medicine, Medical School, Hungary; 12. Department of Surgery, Medical School,
University of Pecs, Pecs, Hungary; 2. János Szentágothai University of Pécs, Pécs, Hungary; 13. First Department of
Research Centre, University of Pécs, Pécs, Hungary; 3. Medicine, Medical School, University of Pécs, Pécs,
Division of Gastroenterology, First Department of Medicine, Hungary; 14. Dr. Réthy Pál Hospital, Békéscsaba, Hungary;
Medical School, University of Pécs, Pécs, Hungary; 4. Heim 15. Division of Translational Medicine, First Department of
Pál Children's Hospital, Budapest, Hungary Medicine, Medical School, University of Pécs, Pécs,
Hungary; 16. Bajcsy-Zsilinszky Hospital, Budapest, Hungary
Introduction: The prevalence of fatty liver disease (FLD)
and that of non-alcoholic fatty liver disease (NAFLD) share Introduction: Pseudocysts are the most common late local
some risk factors known to exacerbate the course of acute complications of acute pancreatitis occurring at least four
pancreatitis (AP). weeks after the onset of the disease.
Aims: This meta-analysis aimed to investigate whether FLD Aims: We aimed to analyze the risk factors and outcomes of
or NAFLD carry a higher risk of untoward outcomes in AP. already existing pseudocysts in acute pancreatitis (AP).
Methods: This meta-analysis was conducted in accordance Methods: Data were extracted from the Acute Pancreatitis
with PRISMA guidelines. We performed a systematic search Registry of the Hungarian Pancreatic Study Group. Cases
in seven medical databases for cohort studies that compared were divided into two groups: patients with already existing
the outcomes of AP for the presence of FLD or NAFLD and pseudocysts (confirmed on imaging within five days from
reported inhospital mortality, AP severity, length of hospital admission) and no pseudocyst. Data on the role of
stay and/or local complications. We calculated pooled odds demographic and risk factors and on-admission pancreatic
ratio (OR) or weighted mean difference (WMD) with 95% enzymes were analyzed. Case numbers, percentages, and
confidence interval (CI) for FLD vs. no-FLD and NAFLD vs medians with standard deviation were calculated.
no-NAFLD comparisons. Results: Out of the 1270 cases, there were 58 already
Results: We included 13 articles in our meta-analysis. AP existing pseudocysts (OLD-P), and 1161 without pseudocyst
patients with FLD were more likely to die (5.09% vs 1.89%, (NO-P). Alcohol was the most common etiology in OLD-P
OR=3.56, CI=1.75-7.22), develop severe AP (16.33% vs 18/58 (31.04%). Patients with OLD-P were predominantly
7.87%, OR=2.67, CI=2.01-3.56), necrotizing pancreatitis male 44/58 (75.86%). In comparison with NO-P, OLD-P
(34.83% vs 15.75%, OR=3.08, CI=2.44-3.90) and had longer cases were associated with: a higher rate of current smoking
in-hospital stay (10.8 vs 9.2 days, WMD=1.46, OR=0.54- (28% vs. 41%), a lower body mass index (27.7±5.6 vs.
2.39). Patients with NAFLD were more likely to have severe 26.1±7.6 kg/m2), a higher number of previous episodes of
AP and longer hospital stay. Both FLD and NAFLD proved to acute pancreatitis (1.9±1.9 vs. 2.2±1.4), a higher rate of
be independent risk factors of a more severe disease course preexisting chronic pancreatitis (4% vs. 18%) and lower on-
(OR=3.68, CI=2.16-6.29 and OR=3.39, CI=1.52-7.56 for admission pancreatic enzyme levels (amylase: 1151±1334
moderate/ severe vs. mild AP, respectively). vs. 843±1050 IU/ml; lipase: 2984±5159 vs. 2403±1696
Conclusion: FLD and NAFLD worsen the outcomes of AP, IU/ml).
which suggests that incorporating FLD or NAFLD into Conclusion: Preexisting pseudocysts in acute pancreatitis
prognostic scoring systems of AP outcomes might improve are associated with the risk factors of recurrent and chronic
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88 Central European Journal of Gastroenterology and Hepatology
Volume 6, Supplementum 2 / November 2020