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    Acute pancreatitis in Turkey: Results of a nationwide multicenter study
    (Elsevier, 2024) Koksal, Aydin Seref; Tozlu, Mukaddes; Sezgin, Orhan; Oguz, Dilek; Kalkan, Ismail Hakk; Altntas, Engin; Yaras, Serkan
    Background: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians ' compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real -world practice. Mortality remains high in severe cases and physicians ' adherence to guidelines during management of the disease needs improvement in some aspects. (c) 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.
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    Prevalence of Pancreatic Steatosis and Its Associated Factors in Turkey: A Nation-Wide Multicenter Study
    (Aves, 2024) Sezgin, Orhan; Yaras, Serkan; Cindoruk, Mehmet; Kasap, Elmas; Unal, Hakan; Koksal, Aydin Seref; Yildirim, Abdullah Emre
    Background/Aims: Pancreatic steatosis (PS) is a pathology associated with metabolic syndrome (MS), endocrin and exocrine disfunctions of the pancreas, and fatty liver. The data on the frequency of PS are very limited. We aimed to evaluate the frequency of PS detected by transabdominal ultrasonography (TAU) in gastroenterology clinics located in different geographical regions of Turkey and the factors associated with it. Materials and Methods: Volunteers were evaluated by TAU for PS and hepatosteatosis (HS), and its degree. Pancreatic stiffness was evaluated by ultrasonographic shear wave elastography (SWE). All demographic, physical, and biochemical parametres were measured. Results: A total of 1700 volunteers from 14 centers throughout Turkey were included in the study. Mean age was 48.03 +/- 20.86 years (56.9% female). Prevalance of PS was detected in 68.9%. In the PS group, age, body mass index (BMI), waist circumference, systolic blood pressure, fasting blood glucose (FBG), lipid levels, insulin resistance, diabetes mellitus, hypertension, MS frequency, and pancreatic SWE score were increasing, and fecal elastase level was decreasing in correlation with the degree of PS. The frequency of HS was 55.5%. Hepatosteatosis [odds ratio (OR): 9.472], increased age (OR: 1.02), and BMI (OR: 1.089) were independent risk factors for the occurrence of PS. Lean -PS rate was 11.8%. The lean -PS group was predominantly female and younger than non -lean PS. Also it has lower blood pressure, FBG, liver enzymes, lipid levels, and HS rates. Conclusion: The frequency of PS was found 68.9% in Turkey. Its relationship was determined with age, BMI, HS, MS (and its components), pancreatic stiffness, and fecal elastase level.