Clinical outcomes of hypertriglyceridemia-associated acute pancreatitis: a prospective multicenter Italian cohort

his prospective multicenter Italian study examined clinical outcomes of hypertriglyceridemia-associated acute pancreatitis (HTG-AP) compared to other etiologies 1. The study included 86 patients across 14 Italian centers, with 38 patients (44.2%) diagnosed with HTG-AP . Key Findings: Local Complications: HTG-AP patients showed significantly higher rates of pancreatic necrosis (36.8% vs. 14.6%) and pseudocyst/walled-off necrosis (15.8% vs. 2.1%). Overall Severity: Despite increased local complications, HTG-AP patients had similar overall severity, ICU admission rates, length of stay, and mortality compared to other AP etiologies. Recurrence: AP recurrence occurred in approximately 9% of patients during one-year follow-up, with similar rates between groups. Conclusions: The study suggests HTG-AP represents a distinct phenotype with preferential pancreatic injury rather than systemic inflammatory response. Early triglyceride measurement is essential for all AP patients regardless of presumed etiology.