Mikó, Alexandra, Farkas, Nelli, Vincze, Áron, Izbéki, Ferenc, Szentesi, Andrea, Hegyi, Péter, Gede, Noémi, Vass, Vivien, Dobszai, Dalma, Gajdán, László, Lillik, Veronika, Sarlós, Patrícia, Bódis, Beáta, Sipter, Emese, Pécsi, Dániel, Márta, Katalin, Tarján, Dorottya, Erőss, Bálint, Faluhelyi, Nándor, Hegyi, Péter Jenő, Engh, Marie, Papp, Mária, Mátrai, Péter, Abonyi-Tóth, Zsolt, Sahin-Tóth, Miklós, Petersen, Ole H.  ORCID: https://orcid.org/0000-0002-6998-0380, Lerch, Markus M., Neoptolemos, John P., Tóth, Kálmán, Lankó, Erzsébet, Kanizsai, Péter, Váncsa, Szilárd, Nagy, Rita, Tinusz, Benedek, Adrienn, Erős, Szakács, Zsolt, Varjú, Péter, Szabó, Anikó Nóra, Zádori, Noémi, Szakó, Lajos, Bálint, Alexandra, Teutsch, Brigitta, Párniczky, Andrea, Mosztbacher, Dóra, Gódi, Szilárd, Bajor, Judit, Czimmer, József, Szabó, Imre, Illés, Anita, Pár, Gabriella, Hágendorn, Roland, Márton, Zsolt, Nagy, Tamás, Miseta, Attila, Vereczkei, András, Kelemen, Dezső, Dunás-Varga, Veronika, Halász, Adrienn, Fejes, Roland, Maurovics-Horvát, Pál, Deák, Pál Ákos, Kocsis, Ibolya, Vásárhelyi, Barna, Zubek, László, Molnár, Zsolt, Petlickij, Fruzsina, Káplár, Klaudia, Hajnády, Zoltán, Zahariev, Olga Julia, Budai, Bettina Csilla, Havelda, Luca, Hussein, Tamás, Lázár, Balázs, Sahin, Péter, Tornai, Tamás, Lipp, Mónika, Fürst, Emese, Tari, Edina, Eperjesi, Orsolya, Bánfalvi, Zoltán, Barna, Boglárka, Urbán, Orsolya, Kormos, Zita, Tóth, Laura and Harnos, Andrea
2026.
Progression of pancreatic morphologic changes and endocrine dysfunction after acute pancreatitis: Preliminary results of the longitudinal Goulash-Plus cohort study.
Gastroenterology
170
(3)
, pp. 631-634.
10.1053/j.gastro.2025.09.034
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Abstract
Approximately 96% to 98% of patients survive acute pancreatitis (AP),1 yet many are exposed to significant long-term risks that are often overlooked. AP may be followed by recurrent acute pancreatitis (RAP) episodes and early chronic pancreatitis (ECP), which can eventually progress to chronic pancreatitis (CP).2,3 Progression of endocrine dysfunction, defined as the combined proportion of newly diagnosed prediabetes and diabetes mellitus (DM), may also reach 35% in the first year after the first AP episode and 59% in the fifth year.4 However, the timing of the progression and underlying mechanisms are not fully understood. The aim of the Goulash-Plus clinical study5 is thus to monitor and investigate the clinical progression of AP in the recurrence and development of CP and the development of endocrine insufficiency (diabetes, prediabetes) after AP. Goulash-Plus is an observational, prospective, multicenter follow-up study enrolling AP patients from 4 centers (ISRCTN registration number: 63396106, ethical permission number: 5753-2/2018/EKU). Patients were grouped into AP, RAP (2 AP episodes without CP diagnosis), ECP (≥3 AP episodes or specific signs on imaging without CP diagnosis), and CP groups based on the morphology status of the pancreas. Endocrine status was used to form normal, prediabetes, and diabetes groups. Patients’ morphologic and endocrine status was determined at inclusion (baseline characteristics) and during the yearly follow-up visits. The basic characteristics of the population and groups are shown in Supplementary Figures 1A and 2A. The 4-year follow-up data for the first 360 patients were analyzed for this ongoing study. Of the population under examination, 43.1% (n = 155) were women and 56.9% (n = 205) were men. The mean age was 54.5 ± 14.6 years. On the basis of the morphologic categorization, 269 patients (74.7%) were classified into the AP group at baseline, 43 (11.9%) into the RAP group, 25 (6.9%) into the ECP group, and 23 (6.4%) into the CP group. By the end of the fourth year of follow-up, the proportion of patients with a RAP, ECP, or CP morphologic status more than doubled to 55.1% (95% confidence interval [CI], 47.48%–62.49%) from 25.3% (95% CI, 21.09%–30.04%) at baseline (Figure 1A). Among the 269 patients with a single AP at baseline, progression to RAP, ECP, or CP affected 35.1% by the fourth year (Figure 1B). Among the 157 with a single AP and normal endocrine status at baseline, 28.6% (95% CI, 22.11%–36.11%) experienced morphologic progression by the fourth year (Figure 1C). The percentage of new patients with recurrent AP episodes was the highest (7.3%) at the first-year follow-up (Figure 1D and Supplementary Figure 1B), whereas the results for patients with progression of pancreatic morphologic changes were 21.2% in the first 2 years and 11.5% in the second 2 years (Figure 1E and Supplementary Figure 1C). The yearly change was statistically significant in the first (P < .001), second (P < .001), and fourth years (P = .0007) (Supplementary Figure 1D).
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Biosciences |
| Publisher: | Elsevier |
| ISSN: | 0016-5085 |
| Date of First Compliant Deposit: | 28 January 2026 |
| Date of Acceptance: | 19 September 2025 |
| Last Modified: | 03 Mar 2026 15:10 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/184258 |
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