A prospective multicentre survey on the treatment of acute pancreatitis in Italy.

Published on Sep 1, 2007in Digestive and Liver Disease3.57
· DOI :10.1016/J.DLD.2007.05.014
R. Pezzilli , Raffaele Pezzilli54
Estimated H-index: 54
(UNIBO: University of Bologna)
+ 6 AuthorsV. Di Carlo50
Estimated H-index: 50
Sources
Abstract
Abstract Background The Italian Association for the Study of the Pancreas released a diagnostic and therapeutic algorithm for acute pancreatitis in 1999. Aim This study focused on the analysis of the therapeutic approach for the treatment of acute pancreatitis in Italy. Patients One thousand, one hundred and seventy-three patients were recruited: 1006 patients (85.8%) had mild acute pancreatitis (MAP) and 167 (14.2%) had the severe acute pancreatitis (SAP); 161 patients showed pancreatic necrosis at computed tomography; 121 patients (10.3%) had sequelae and 36 (3.1%) died. Results Non-steroidal anti-inflammatory drugs and tramadol were used more frequently in patients with the MAP whereas opioids and the association schedules were used more frequently in patients with the SAP (P  Conclusions The results of this survey indicate a lack of compliance with the guidelines which regard the indications mainly for interventional endoscopy and surgery.
📖 Papers frequently viewed together
200519.82Gut
13 Authors (Colin D. Johnson, ..., J. Kelly)
32 Citations
1,317 Citations
200519.82Gut
1 Author (Ireland)
757 Citations
References37
Newest
#1Mohammed Al-Omran (KSU: King Saud University)H-Index: 33
#1Mohammed Al-Omran (KSU: King Saud University)H-Index: 15
Last. Lubna A. Al-Ansary (KSU: King Saud University)H-Index: 13
view all 4 authors...
Background Acute pancreatitis creates a catabolic stress state promoting a systemic inflammatory response and nutritional deterioration. Adequate supply of nutrients plays an important role in recovery. Total parenteral nutrition (TPN) has been standard practice for providing exogenous nutrients to patients with severe acute pancreatitis. However, recent data suggest that enteral nutrition (EN) is not only feasible, but safer and more effective.Therefore, we sought to update our systematic revie...
328 CitationsSource
#1Dilip Parekh (SC: University of Southern California)H-Index: 12
Hypothesis Open surgery for pancreatic debridement is often associated with major morbidity such as wound complications, fascial dehiscence, and intestinal fistulae. Hand-assisted laparoscopic surgery (HALS) is useful for complex abdominal procedures since the benefits of traditional laparoscopic surgery are retained. Published experience with HALS for pancreatic debridement is limited to anecdotal case reports. Setting University-affiliated private and public hospitals. Patients Twenty-three pa...
193 CitationsSource
Background and objective The use of antibiotics in acute pancreatitis despite recent clinical trials remains controversial. The aim of this study is to review the latest clinical trials and guidelines about antibiotics in acute pancreatitis and determine its proper use.
6 CitationsSource
785 CitationsSource
#1Yasutoshi Kimura (Sapporo Medical University)H-Index: 45
#2Tadahiro Takada (Teikyo University)H-Index: 68
Last. Seiki Matsuno (Tohoku University)H-Index: 71
view all 14 authors...
Gallstones, along with alcohol, are one of the primary etiological factors of acute pancreatitis, and knowledge of the etiology as well as the diagnosis and management of gallstones, is crucial for managing acute pancreatitis. Because of this, evidence regarding the management of gallstone-induced pancreatitis in Japan was collected, and recommendation levels were established by comparing current clinical practices with optimal clinical practices. The JPN Guidelines for managing gallstone-induce...
94 CitationsSource
: In recent years, a number of articles have been published on the treatment of acute pancreatitis in experimental models and most of them were published about animals with mild disease. However, it is difficult to translate these results into clinical practice. For example, infliximab, a monoclonal TNF antibody, was experimentally tested in rats and it was able to significantly reduce the pathologic score and serum amylase activity, and also alleviate alveolar edema and acute respiratory distre...
22 Citations
#1Bodil Andersson (Lund University)H-Index: 24
#2Hanna Olin (Lund University)H-Index: 2
Last. Roland Andersson (Lund University)H-Index: 79
view all 4 authors...
Background/Aims: Severe acute pancreatitis (SAP) is associated with a high morbidity and mortality. The aim was to evaluate treatment, risk factors and outcome in SAP in a centre wi
52 CitationsSource
Objectives: Acute pancreatitis remains a potentially life-threatening disease. Despite national and international consensus conferences, the management of acute pancreatitis still differs among hospitals and countries. Methods: This study analyzes the outcome of acute pancreatitis treated by a conservative strategy in a community-based hospital. The strategy followed a conservative interpretation of German consensus guidelines but did not determine medical decisions by a prospective protocol. Re...
15 CitationsSource
#1J Keller (UHH: University of Hamburg)H-Index: 1
#2P. LayerH-Index: 1
Optimal digestion and absorption of nutrients requires a complex interaction among motor and secretory functions of the gastrointestinal tract. Digestion of macronutrients is a prerequisite for absorption and occurs mostly via enzymatic hydrolysis. In this context, pancreatic enzymes, in particular lipase, amylase, trypsin, and chymotrypsin, play the most important role but several brush border enzymes as well as other pancreatic and extrapancreatic enzymes also participate in macronutrient dige...
367 CitationsSource
#1Colin D. JohnsonH-Index: 55
#2R.B. CharnleyH-Index: 1
Last. J. KellyH-Index: 1
view all 13 authors...
32 CitationsSource
Cited By106
Newest
#1Mauro PoddaH-Index: 29
#2Gianluca Pellino (Seconda Università degli Studi di Napoli)H-Index: 28
Last. Stavros Gourgiotis (University of Cambridge)H-Index: 2
view all 0 authors...
Despite existing evidence-based practice guidelines for the management of biliary acute pancreatitis (AP), the clinical compliance with recommendations is overall poor. Studies in this field have identified significant discrepancies between evidence-based recommendations and daily clinical practice. The most commonly reported gaps between clinical practice and AP guidelines include the indications for CT scan, need and timing of artificial nutritional support, indications for antibiotics, and su...
Source
#1Aditya Ashok (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 1
#2Mahya Faghih (Johns Hopkins University)H-Index: 8
Last. Vikesh K. Singh (Johns Hopkins University)H-Index: 48
view all 15 authors...
BACKGROUND Prior studies have evaluated clinical characteristics associated with opioid dose requirements in hospitalized patients with acute pancreatitis (AP) but did not incorporate morphologic findings on CT imaging. AIMS We sought to determine whether morphologic severity on imaging is independently associated with opioid dose requirements in AP. METHODS Adult inpatients with a diagnosis of AP from 2006 to 2017 were reviewed. The highest modified CT severity index (MCTSI) score and the daily...
Source
#1Ashish SharmaH-Index: 1
#2Apoorva Madapu (Huntsville Hospital System)
Last. Anil Jha
view all 5 authors...
The laparoscopic cholecystectomy is the definite treatment of acute gallstone pancreatitis, but the timing remains controversial. We aimed to evaluate trends, prevalence, and outcomes of laparoscopic cholecystectomy amongst patients with acute gallstone pancreatitis in index hospitalization done at different time intervals. We performed a retrospective study using Nationwide Inpatient Sample (years 2003–2014) with adult hospitalizations with acute gallstone pancreatitis who underwent laparoscopi...
Source
#1Daniel Hughes (University of Oxford)H-Index: 7
#2Gareth Morris-Stiff (Cleveland Clinic)H-Index: 37
Abstract Background /Objectives: A paradigm shift has been observed in the management of mild gallstone pancreatitis; current guidelines advocate definitive cholecystectomy on the index admission. Despite the abundance of published guidelines, uncertainty remains with regard to the timing of cholecystectomy in moderate and severe acute pancreatitis (MAP/SAP), and no definitive consensus has been declared. This systematic review aimed to evaluate the published guidelines and subsequent evidence q...
1 CitationsSource
Introduction: The Italian Association for the Study of the Pancreas promoted a survey on exploring the point of view of Italian pancreatologists regarding the diagnosis and the treatment of acute pancreatitis (AP) due to hypertriglyceridemia (HAP). Method: A questionnaire was administered, and it contained four sections regarding epidemiological characteristics of the participants, how the participants arrived at a diagnosis of the disease, how they treated familial hypertriglyceridemia, and whe...
Source
#1Wiriyaporn Ridtitid (Chula: Chulalongkorn University)H-Index: 16
#2Santi Kulpatcharapong (Chula: Chulalongkorn University)H-Index: 3
Last. Rungsun Rerknimitr (Chula: Chulalongkorn University)H-Index: 31
view all 6 authors...
Background Early cholecystectomy (EC) is recommended in patients with acute biliary pancreatitis (ABP). In real-life practice, cholecystectomy is frequently deferred due to various reasons and delayed cholecystectomy (DC) is performed instead. Endoscopic sphincterotomy (ES) is an alternative to prevent recurrent pancreatitis, however other gallstone-related complications (GCs) may still develop. We aimed to determine the impact of ES on future GCs in patients with non-severe acute biliary pancre...
2 CitationsSource
#1Nick Moody (NUH: Nottingham University Hospitals NHS Trust)H-Index: 2
#2Alfred Adiamah (NUH: Nottingham University Hospitals NHS Trust)H-Index: 8
Last. Dhanwant Gomez (NUH: Nottingham University Hospitals NHS Trust)H-Index: 7
view all 4 authors...
ANTECEDENTES: Los calculos biliares son el factor etiologico en el 30-50% de todas las formas de pancreatitis aguda. Si bien el tratamiento de la pancreatitis aguda suele ser de soporte, el tratamiento definitivo de la pancreatitis por litiasis biliar es la colecistectomia. La guia de la British Society of Gastroenterology sugiere efectuar el tratamiento definitivo en el mismo ingreso o dentro de las 2 semanas posteriores al alta, mientras que la International Association of Pancreatology y la A...
11 CitationsSource
#1Jorge D. Machicado (Mayo Clinic)H-Index: 13
#1Jorge D. Machicado (Mayo Clinic)H-Index: 2
Last. Georgios I. Papachristou (OSU: Ohio State University)H-Index: 49
view all 2 authors...
Purpose of reviewThe present article will focus in pharmacologic agents that have been studied to improve acute pancreatitis outcomes, and to prevent the disease at different levels.Recent findingsToo little and too much early fluid resuscitation can be harmful. The optimal volume, rate, and duratio
4 CitationsSource
#1Raffaele PezzilliH-Index: 54
#2Fabio Caputo (UNIBO: University of Bologna)H-Index: 28
Last. Emanuele ScafatoH-Index: 41
view all 16 authors...
Current estimates of the prevalence of chronic pancreatitis, one of the most common causes of exocrine pancreatic insufficiency, are in the range of 3-10 per 100,000 people in many parts of the world. Alcohol consumption is a very important risk factor for exocrine pancreatic insufficiency and is involved in nearly half of all cases. The main hypothesis regarding the role of chronic alcohol consumption in pancreatitis is that there must be additional environmental or genetic risk factors involve...
6 CitationsSource
#1Nasim Parsa (Johns Hopkins University)H-Index: 6
#2Mahya Faghih (Johns Hopkins University)H-Index: 8
Last. Vikesh K. SinghH-Index: 48
view all 12 authors...
ObjectivesOpioids are commonly required for abdominal pain in hospitalized patients with acute pancreatitis (AP). The factors associated with increased opioid requirements are unknown.MethodsThe medical records of adult inpatients with AP from 2006 to 2016 were reviewed. Patients with chronic pancre
4 CitationsSource