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Objectives <p>This study aimed to clarify the current clinico-epidemiological characteristics of acute pancreatitis (AP) in Japan.</p> Methods <p>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.</p> Results <p>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&#xa0;years for males and 65.4&#xa0;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.</p> Conclusions <p>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.</p>

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

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  • 发表日期：

    2025年7月31日

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  • Yuichi Tanaka,
  • Atsushi Masamune,
  • Ryotaro Matsumoto,
  • Tetsuya Takikawa,
  • Yu Tanaka,
  • Shin Hamada,
  • Shin Miura,
  • Kiyoshi Kume,
  • Yoshifumi Takeyama,
  • Kazuhiro Kikuta,
  • Toshiaki Abe,
  • Takahiro Abe,
  • Makoto Abue,
  • Takumi Akiyama,
  • Toshihiko Arizumi,
  • Shohei Asada,
  • Shunjiro Azuma,
  • Kazuro Chiba,
  • Takahiro Dohmen,
  • Hiroyoshi Doi,
  • Takaaki Eguchi,
  • Hiroyuki Endo,
  • Nao Fujimori,
  • Yuko Fujimoto,
  • Junichi Fujiwara,
  • Akihisa Fukuda,
  • Naoya Fukuda,
  • Yoshihisa Fukuda,
  • Masataka Fukue,
  • Hiroyuki Funayama,
  • Toshifumi Gushima,
  • Shin-Ichiro Hagiwara,
  • Hideaki Hamano,
  • Yasushi Hamaya,
  • Kiyotaka Hashizume,
  • Kenji Hattori,
  • Nobuhiro Hattori,
  • Aoi Hayasaki,
  • Hidehiro Hayashi,
  • Kazuki Hayashi,
  • Kazunao Hayashi,
  • Koki Hayashi,
  • Sumio Hirose,
  • Masashi Hirota,
  • Morihisa Hirota,
  • Takashi Hisamatsu,
  • Yasuki Hori,
  • Tatsuya Hoshi,
  • Naoko Hyodo,
  • Kazunari Ibusuki,
  • Akihito Ida,
  • Takao Iemoto,
  • Takamichi Igarashi,
  • Takeshi Iida,
  • Sadaharu Iio,
  • Yuta Iizawa,
  • Tsukasa Ikeura,
  • Tsunao Imamura,
  • Tomoko Inagaki,
  • Osamu Inatomi,
  • Hiroyuki Inoue,
  • Kentaro Inoue,
  • Tadahisa Inoue,
  • Kuniyasu Irie,
  • Shoichi Irie,
  • Masaharu Ishida,
  • Kazunori Ishige,
  • Akio Ishii,
  • Jun Ishii,
  • Hajime Isomoto,
  • Shuichi Ito,
  • Takashi Ito,
  • Tetsuhide Ito,
  • Eisuke Iwasaki,
  • Junji Iwasaki,
  • Takuji Iwashita,
  • Keisuke Iwata,
  • Tomoyuki Iwata,
  • Toshinobu Izumi,
  • Naruomi Jinno,
  • Takuo Kado,
  • Seiji Kaino,
  • Tetsuro Kajiwara,
  • Toyoma Kaku,
  • Takahiro Kamiga,
  • Akira Kanamori,
  • Keiko Kaneko,
  • Katsuhiro Kanemaru,
  • Atsushi Kanno,
  • Satoshi Kasugai,
  • Fumiya Kataoka,
  • Shin Kato,
  • Junji Kawaguchi,
  • Shinya Kawaguchi,
  • Kenji Kawaguti,
  • Ryuichi Kawahara,
  • Yoshinari Kawahara,
  • Tomoaki Kawai,
  • Yuki Kawaji,
  • Hiroshi Kawakami,
  • Toru Kawamoto,
  • Osamu Kido,
  • Yui Kishimoto,
  • Hideki Kitada,
  • Takanori Kitaguchi,
  • Katsuya Kitamura,
  • Rena Kitano,
  • Kasenn Kobashigawa,
  • Masanori Kobayashi,
  • Ikuhiro Kobori,
  • Yuzo Kodama,
  • Shiro Kohi,
  • Kazuhiko Koike,
  • Mitsuhito Koizumi,
  • Takamitsu Komaki,
  • Shunsuke Komoto,
  • Takuya Komura,
  • Naoki Konno,
  • Yudai Koya,
  • Koji Kubota,
  • Mizuki Kuramochi,
  • Hitoshi Kurata,
  • Hideaki Kurihara,
  • Michio Kuroki,
  • Masaki Kuwatani,
  • Takuro Maeda,
  • Isamu Makino,
  • Tomoo Manaka,
  • Koichiro Mandai,
  • Toru Maruo,
  • Akinori Maruta,
  • Yuichiro Maruyama,
  • Yukiko Masuda,
  • Takayuki Masuo,
  • Saburo Matsubara,
  • Satoshi Matsukuma,
  • Hideo Matsumoto,
  • Kazuyuki Matsumoto,
  • Ryusuke Matsumoto,
  • Yosuke Matsumura,
  • Susumu Matsuo,
  • Kisyo Mihara,
  • Kei Mitsuhashi,
  • Tsukasa Miyagahara,
  • Ichiro Miyajima,
  • Masaki Miyazawa,
  • Shugo Mizuno,
  • Suguru Mizuno,
  • Kosuke Mori,
  • Masayo Motoya,
  • Shuntaro Mukai,
  • Yoshiki Murakami,
  • Yoshiyuki Murawaki,
  • Yoko Murayama,
  • Ryoji Nagamura,
  • Hayato Nagase,
  • Kazuyoshi Nagata,
  • Kazunari Nakahara,
  • Takaaki Nakahira,
  • Yoshitaka Nakai,
  • Yousuke Nakai,
  • Akira Nakamura,
  • Kazunori Nakaoka,
  • Hiroshi Nakase,
  • Atsushi Nakazawa,
  • Yoshihito Nawa,
  • Yusuke Niina,
  • Tsutomu Nishida,
  • Takayoshi Nishino,
  • Shotaro Noge,
  • Tatsuro Oaku,
  • Tsuneyoshi Ogawa,
  • Hideharu Ogiyama,
  • Takaya Oguchi,
  • Yoshito Ogura,
  • Akihiko Ohata,
  • Masahiro Ohtani,
  • Hiroshi Ohyama,
  • Hiromitsu Oka,
  • Shiro Oka,
  • Toshimasa Okada,
  • Yasuyuki Okada,
  • Hiromasa Okamoto,
  • Kazuhisa Okamoto,
  • Tomohiro Okamoto,
  • Akihito Okazaki,
  • Kazuichi Okazaki,
  • Tetsuya Okino,
  • Osamu Okochi,
  • Fumihiro Okumura,
  • Kosuke Okuwaki,
  • Kiyohiro Oshima,
  • Kazuhiro Otani,
  • Takao Oyama,
  • Akira Saeki,
  • Kei Saito,
  • Michihiro Saito,
  • Nozomu Saito,
  • Toshitaka Sakai,
  • Yoshitaka Sakai,
  • Misako Sakano,
  • Takanori Sano,
  • Yoshihiro Sasaki,
  • Yuichi Sasakura,
  • Masaaki Satake,
  • Masahiro Sato,
  • Satoshi Sato,
  • Yoichiro Sato,
  • Akihiko Satoh,
  • Yugo Sawai,
  • Masanari Sekine,
  • Yasumasa Sekino,
  • Morimichi Setsuda,
  • Minoru Shigekawa,
  • Masahiro Shiihara,
  • Masaaki Shimatani,
  • Takehiro Shimizu,
  • Toru Shinkai,
  • Nobuhiko Shinohara,
  • Hideyuki Shiomi,
  • Nakao Shirahata,
  • Masayuki Sho,
  • Yoshio Sogame,
  • Takahiro Suda,
  • Shigeyuki Suenaga,
  • Hajime Sumi,
  • Yasuyuki Sumida,
  • Kaoru Suzuki,
  • Keiichi Suzuki,
  • Masato Suzuki,
  • Noriaki Suzuki,
  • Yuhei Suzuki,
  • Kiyoshi Suzumura,
  • Akinari Tabaru,
  • Rei Takaesu,
  • Kosuke Takagaki,
  • Tadayuki Takagi,
  • Kenichi Takahashi,
  • Kenji Takahashi,
  • Seiichi Takahashi,
  • Shinichi Takano,
  • Yuichi Takano,
  • Yusuke Takasaki,
  • Mamoru Takenaka,
  • Hiroshi Tamagawa,
  • Eiji Tamoto,
  • Yu Tanaka,
  • Shiroh Tanoue,
  • Shuji Terai,
  • Hiroaki Terajima,
  • Masao Toki,
  • Yuichi Torisu,
  • Takayuki Tsujikawa,
  • Keisuke Tsukamoto,
  • Yuki Tsukamoto,
  • Yosuke Tsuruga,
  • Ken Tsushima,
  • Hidehiko Tuda,
  • Kazushige Uchida,
  • Masayuki Ueno,
  • Yoshiyuki Ueno,
  • Jun Unno,
  • Takahiro Urata,
  • Sinnitirou Watanabe,
  • Kenta Yamada,
  • Reiko Yamada,
  • Hirokazu Yamagami,
  • Akira Yamamiya,
  • Satoshi Yamamoto,
  • Kohei Yamanouchi,
  • Kentaro Yamao,
  • Suguru Yamashita,
  • Jun Yashika,
  • Hiroaki Yasuda,
  • Ichiro Yasuda,
  • Tatsuji Yogi,
  • Tomoyuki Yokota,
  • Kentaro Yoneda,
  • Hideo Yoshida,
  • Hiroshi Yoshida,
  • Naoki Yoshida,
  • Hayato Yoshimura,
  • Reiko Yoshioka

摘要

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.