Nationwide epidemiological survey of acute pancreatitis in Japan, 2021: the impact of the COVID-19 pandemic and revised clinical guidelines

  • Hyogo Prefectural Nishinomiya Hospital
  • , Japan Community Health Care Organization, Shimonoseki Medical Center
  • , Gunma University Graduate School of Medicine
  • , Kitaharima Medical Center
  • , Narita Memorial Hospital
  • , Kagoshima Prefectural Satsunan Hospital
  • , Haibara General Hospital
  • , Kesennuma City Hospital
  • , Nagoya City University Graduate School of Medical Sciences
  • , Iryouhoujin Eiwakai Izumikawa Hosp
  • , Tohoku Medical and Pharmaceutical University
  • , Okazaki City Hospital
  • , Yamanashi Prefectural Central Hospital
  • , Tamakyuryo Hospital
  • , Graduate School of Medical and Dental Sciences, Niigata University
  • , Nagoya City University East Medical Center
  • , Tohoku University Graduate School of Medicine
  • , Mie University Hospital
  • , Osaka Medical and Pharmaceutical University
  • , Hyogo Emergency Medical Center
    • Aichi Prefectural Welfare Federation of Agricultural Cooperatives Kainan Hospital, Hamamatsu University School of Medicine, Nagano Prefectural Kiso Hospital, Osaka Women’s and Children’s Hospital, Hamanomachi Hospital, Saka General Hospital, Medical Corporation Tokushukai Koga General Hospital, Fukuoka Tokushukai Hospital, Kushiro City Hospital, Kyoto University Graduate School of Medicine, Omagari Kousei Medical Center, Nagato General Hospital, Kyushu University, Japan Community Health Care Organization Sendai Hospital, Osaka Saiseikai Nakatsu Hospital, Shin-yurigaoka General Hospital, Yuri Kumiai General Hospital, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Medical Research Institute Kitano Hospital, Nara Medical University, Teikyo University School of Medicine, Saga University, Miyagi Cancer Center, Maebashi Red Cross Hospital, Tohoku University Graduate School of Medicine, Kochi University, Yokohama City University Medical Center, NHO Sendai Medical Center, Iwaki City Medical Center, Eiju General Hospital, Takita, Matsuyama Red Cross Hospital, Ichinomiyanishi Hospital, University of Toyama, Saiseikai Shiga Hospital, Daido Hospital, Ome Municipal General Hospital, Nagoya University Hospital, Takagi Hospital, Fujita Health University Bantane Hospital, Dokkyo Medical University School of Medicine, Ishikiriseiki Hospital, Mie University Graduate School of Medicine, Ichinomiya Municipal Hospital, Iryouhouzinsouseikai Watanabeichoukagekabyouin, Kumamoto Red Cross Hospital, Japanese Red Cross Ishinomaki Hospital, Faculty of Medicine, Yamagata University, Kurashiki Central Hospital, Kochi University, Akita Kousei Hsp, JA Onomichi General Hospital, Hakodate Municipal Hospital, NHO Hokkaido Medical Center, Kawasaki Saiwai Hospital, Teikyou University Mizonokuchi Hospital, The Jikei University School of Medicine, Kyorin University, Medical Research Institute Kitano Hospital, Graduate School of Medical and Dental Sciences, Niigata University, Graduate School of Medical and Dental Sciences Kagoshima University, Tohoku Rosai Hospital, Obihiro Kosei Hospital, Otemae Hospital, Kindai University Hospital, Juntendo University, Showa University Fujigaoka Hospital, (University of Yamanashi, Iwaki City Medical Center, Asahikawa Medical University Hospital, Akita University, Fukushima Medical University, Enshu Hospital, Fukuoka University, Wakamatsu Hospital of the University of Occupational and Environmental Health, Sizuoka Saiseikai General Hospital, NHO Takasaki General Medical Center, Sendai City Hospital, NHO Yokohama Medical Center, NHO Tochigi Medical Center, Obihiro Daiichi Hospital, Rakuwakai Otowa Hospital, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Yamaguchi University, Kansairosai, Kyoto Prefectural University of Medicine, Nara Medical University, Yamagata Prefectural Central Hospital, Hyogo Medical University, School of Medicine, University of Occupational and Environmental Health, Mie University Hospital, Gunma University, Kansai Medical University Medical Center, Tokyo Medical University Ibaraki Medical Center, Osaka University, Japanese Red Cross Society ISE HOSPITAL, Tohoku University Graduate School of Medicine, Jichi Medical University, Saitama Medical Center, Japanese Red Cross Society Osaka Hospital, South Miyagi Medical Center, Toho University Omori Hospital, Hirosaki University Hospital, Hatinohe City Hospital, Kenwakai Otemachi Hospital, Saiseikai Utsunomiya Hospital, National Disaster Medical Center, Tohoku University Graduate School of Medicine, Tohoku University Graduate School of Medicine, Osaki Citizen Hospital, Sendai City Medical Center, Noshiro Kosei Medical Center, Toho University Ohashi Medical Center, Nihon University School of Medicine, National Hospital Organization Nagasaki Medical Center, Tsugaru General Hospital, Shimonoseki City Hospital, Gunma University Hospital, Kitasato University Hospital, Gifu Prefectural Tajimi Hospital, Tosei General Hospital, Kumamoto Saishun Medical Center, Kansai Medical University Kori Hospital, NHO Higashihiroshima Medical Center, Hyogo Medical University Hospital, Oita University Faculty of Medicine, Shirakawa Kousei General Hospital, Tokushima University Hospital, Kawasaki Medical School Hospital, Hiroshima University Hospital, Nagaoka Chuo General Hospital, Chiba University Hospital, University of Fukui, Fujieda Municipal General Hospital, Imakiire General Hosptal, Suwa Hospital, Ikeda Municipal Hospital, Fukuyama City Hospital, Kyotango City Yasaka Hospital, Saga Medical Center Koseikan, Tokyo Women’s Medical University, Yachiyo Medica Center, Toyonaka Municipal Hospital, Kitakyushu Municipal Medical Center, Faculty of Medicine, Yamagata University, Saiseikai Central Hospital, Sapporo Medical University School of Medicine, Fujita Health University, Shinshu University, The University of Tokyo, Kyoto Katsura Hospital, Saiseikai Hyuga Hospital, St. Marianna University School of Medicine, Nagasaki Harbor Medical Center, Hirosaki University, Okinawa Kyodo Hospital, Itami City Hospital, Matsue City Hospital, Asahi University Hospital, Tokyo Medical University, Teine-Keijinkai Hospital, Saga University Hospital, Saitama Medical University Hospital, Mie University Hospital, Kanazawa University, Kumamoto Central Hospital, (Beppu Medical Center, Tokeidai Memorial Hospital, Kawasaki Municipal Kawasaki Hospital, NHO Fukuokahigashi Medical Center, Chiba Emergency Medical Center, (Obihiro Kosei Hospital, Okayama University Hospital, Mitsugi General Hospital, Japan Community Health Care Organization Tokuyama Central Hospital, Saitama Medical Center, Saitama Medical University, Tohoku University Graduate School of Medicine, (National Hospital Organization Nagasaki Medical Center, Sasebo Kyosai Hospital, Gifu Prefectural General Medical Center, Fukuoka University Chikushi Hospital, Kyoto Second Red Cross Hospital, Tohoku University Graduate School of Medicine, Kanazawa University, National Hospital Organization MinamiKyushu Hospital, Hokkaido University, Yamagata City Hospital Saiseikan, Kanamach Central Hospital, Tokyo Metropolitan Ohtsuka Hospital, National Hospital Organization Saitama Hospital, Shinshu University School of Medicine, Kyushu Rosai Hospital Moji Medical Center, Fukushima Red Cross Hospital, NHO Kanazawa Medical Center, National Defense Medical College, Tondabayashi Hospital, Ehime University Graduate School of Medicine, The Jikei University Daisan Hospital, University of Occupational and Environmental Health, Kobe University Hospital, Dokkyo Medical University Saitama Medical Center, Institute of Science Tokyo, Urasoesougoubyouin, Aichi Medical University, Tokyo Medical University Hachioji Medical Center, Fukuoka University, Kumamoto Red Cross Hospital, Kanto Rosai Hospital, Iwate Prefectural Central Hospital, Asahikawa-Kosei General Hospital, Miyazaki University, Wakayama Medical University, Iwamizawa Municipal General Hospital, Kunisaki City Hospital, Yame General Hospital, Iwakuni Medical Association Hospital, Shizuoka General Hospital, Matsunami General Hospital, Sapporo City General Hospital, Matsunami General Hospital, Iwate Medical University, Jichi Medical School, Miyazaki Prefectural Nobeoka Hospital, Nippon Medical School Hospital, NHO Utsunomiya National Hospital, Sendai Tokushukai Hospital, Kyushu Medical Center, Shiroishi　Kyouritu　Hospital, NHO Kanmon Medical Center, Akashi Medical Center, Japan Community Health Care Organization Chukyo Hospital, Himeji Medical Center, Tokyo-kita Medical Center, Gifu Municipal Hospital, Gifu University Hospital, Shimane Prefectural Central Hospital, Keio University School of Medicine, Fukuoka Sanno Hospital, Kansai Medical University, Yokote Municipal Hospital, Tottori University Hospital, Toho University Faculty of Medicine, Takarazuka City Hospital, Kasumigaura Medical Center, Tohoku University, Koshigaya, Yokohama City University, Aichi Medical University, Kawasaki Municipal Hospital, Sapporo Medical University Hospital, Shiga University of Medical Science, Kasai City Hospital, Toranomon Hospital, Kansai Medical University, Narita Red Cross Hospital

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Objectives: This study aimed to clarify the current clinico-epidemiological characteristics of acute pancreatitis (AP) in Japan. Methods: We conducted a two-stage nationwide survey of patients with AP treated at selected hospitals in 2021, during the COVID-19 pandemic. The first stage estimated the total number of AP patients, while the second collected detailed clinical data. Results: The estimated number of AP patients requiring hospitalization was 61,080, with an overall incidence rate of 49 per 100,000 persons, decreasing from 78,450 in 2016. Detailed clinical data were obtained for 4,375 patients, including 1,362 (31.1%) classified as severe. The male-to-female ratio was 2.0, with mean ages at onset of 60.1 years for males and 65.4 years for females. The three major causes were alcohol (31.2%), gallstones (22.5%), and idiopathic etiology (22.1%). The AP-associated in-hospital mortality rate was 2.1% in all AP and 5.3% in severe cases, down from 6.1% in the 2016 survey. Antibiotics were administered to 61.2% of mild cases, a significant reduction from 94.5% in 2016. Enteral nutrition was provided to 56.9% of severe cases, up from 31.8% in 2016. Among 124 patients undergoing interventional drainage for walled-off necrosis, 57 were treated using a step-up approach. Notably, no patients underwent upfront surgery as the initial treatment. Conclusions: During the pandemic, the estimated number of AP cases requiring hospitalization declined for the first time in nearly four decades. Mortality in severe cases improved, and adherence to clinical guidelines on prophylactic antibiotics and enteral nutrition also improved, indicating enhanced management of AP in Japan.

Original languageEnglish
Pages (from-to)1437-1448
Number of pages12
JournalJournal of Gastroenterology
Volume60
Issue number11
DOIs
Publication statusPublished - 11-2025

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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