S0128 Clinically Significant Ileus in Patients With Acute Pancreatitis Is Associated With Severity of Pancreatitis, Not Volume of Fluid Resuscitation

INTRODUCTION: Aggressive fluid resuscitation has been the standard of care for acute pancreatitis but a tailored approach appears to have best outcomes. Liberal perioperative fluid administration is an independent risk factor for the development of ileus and delayed recovery of gastrointestinal functions after abdominal surgeries. The recovery of gastrointestinal functions is an important determinant of course of acute pancreatitis and the timing of hospital discharge. Here, we evaluated association between fluid resuscitation volume and clinically significant ileus development in patients with acute pancreatitis. METHODS: Consecutive adults admitted with acute pancreatitis between Jan 2014 and Dec 2019 to our academic and two community hospital were included. The Bedside Index for Severe Acute Pancreatitis (BISAP) and systemic inflammatory response syndrome (SIRS) were used to predict severity of pancreatitis based on their readily availability and ease in use. Severity of pancreatitis was determined based on the Revised Atlanta classification. Fluid resuscitation volume was collected as administered in time 0 to 24 hours, 0 to 48 hours and 0 to 72 hours. Clinically significant ileus was determined based on treating physician’s assessment with radiological diagnosis. RESULTS: A total of 441 unique patients were included in the study. Among them, 49 (11%) patients developed clinically significant ileus. Demographics of patients with or without ileus are summarized in Table 1 and were similar between the two groups. On univariate analysis, the presence of SIRS syndrome (<0.001), and higher BISAP scores (P < 0.001) were associated with ileus but pancreatitis etiology and fluid resuscitation volume were not (see table 2). However, Ileus development was associated with increased length of hospital stay and admission to intensive care unit. CONCLUSION: Our data showed that ileus development is associated with severity of acute pancreatitis, not with fluid resuscitation volume or patient demographic.Table 1.: Demographic characteristics.Table 2.: Clinical and laboratory characteristics.