Consensus guidelines on severe acute pancreatitis.

Published on Jul 1, 2015in Digestive and Liver Disease3.57
· DOI :10.1016/J.DLD.2015.03.022
Raffaele Pezzilli54
Estimated H-index: 54
(UNIBO: University of Bologna),
Alessandro Zerbi57
Estimated H-index: 57
+ 17 AuthorsGianpaolo Balzano44
Estimated H-index: 44
(UniSR: Vita-Salute San Raffaele University)
Sources
Abstract
Abstract This Position Paper contains clinically oriented guidelines by the Italian Association for the Study of the Pancreas (AISP) for the diagnosis and treatment of severe acute pancreatitis. The statements were formulated by three working groups of experts who searched and analysed the most recent literature; a consensus process was then performed using a modified Delphi procedure. The statements provide recommendations on the most appropriate definition of the complications of severe acute pancreatitis, the diagnostic approach and the timing of conservative as well as interventional endoscopic, radiological and surgical treatments.
📖 Papers frequently viewed together
1 Author (H. van Goor)
785 Citations
201319.82Gut
2,517 Citations
959 Citations
References217
Newest
#1S. van BrunschotH-Index: 2
#1S. van BrunschotH-Index: 2
Last. Abstr Act (Radboud University Nijmegen)H-Index: 1
view all 8 authors...
BACKGROUND Early enteral feeding through a nasoenteric feeding tube is often used in patients with severe acute pancreatitis to prevent gut-derived infections, but evidence to support this strategy is limited. We conducted a multicenter, randomized trial comparing early nasoenteric tube feeding with an oral diet at 72 hours after presentation to the emergency department in patients with acute pancreatitis. METHODS We enrolled patients with acute pancreatitis who were at high risk for complicatio...
138 CitationsSource
#1Takeshi Seta (Kyoto University)H-Index: 6
#2Yoshinori NoguchiH-Index: 26
Last. Takeo Nakayama (Kyoto University)H-Index: 42
view all 4 authors...
Background The intravenous use of protease inhibitors in patients with acute pancreatitis is still controversial. The purpose of this study was to evaluate the effectiveness of protease inhibitors intravenously administered to prevent pancreatitis-associated complications.
28 CitationsSource
#1Mei Lan Cui (Yeungnam University)H-Index: 1
#2Kook Hyun Kim (Yeungnam University)H-Index: 13
Last. Tae Nyeun Kim (Yeungnam University)H-Index: 21
view all 9 authors...
Background Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems. Acute fluid collections and pseudocyst formation are the most frequent complications of acute pancreatitis.
60 CitationsSource
#1Emma L. Aitken (Cardiff University)H-Index: 1
#2Vivienne GoughH-Index: 2
Last. Angus MacdonaldH-Index: 9
view all 4 authors...
Background Intra-abdominal hypertension (IAH) is predictive of adverse outcome in critically ill patients; however, its role in acute pancreatitis is unclear, and prospective studies are lacking. We aimed to determine the overall incidence and predictive value of IAH on mortality in acute pancreatitis. Methods Transvesical IAP was measured on admission and every 4 hours within high-dependency unit/intensive care unit. Serum biochemistry and physiologic parameters permitted calculation of Acute P...
20 CitationsSource
#1Stephanie L M Das (University of Auckland)H-Index: 5
#2Primal P. Singh (University of Auckland)H-Index: 12
Last. Maxim S. Petrov (University of Auckland)H-Index: 30
view all 6 authors...
Background Diabetes mellitus (DM) is common in the general population and it poses a heavy burden to society in the form of long-term disability, healthcare use and costs. The pancreas is a key player in glucose homeostasis, but the occurrence of newly diagnosed DM after acute pancreatitis (AP), the most frequent disease of the pancreas, has never been assessed systematically. The aim of this study was to conduct a systematic literature review to determine the prevalence and time course of DM an...
146 CitationsSource
#1John FitzpatrickH-Index: 1
#2Raj BhatH-Index: 1
Last. Jamie A. YoungH-Index: 2
view all 3 authors...
OBJECTIVE: The aim of this study was to analyze the role of radiologic embolization as a diagnostic and therapeutic modality for severe hemorrhage in pancreatitis. METHODS: All patients with pancreatitis who underwent mesenteric angiography for a 3-year period were identified and analyzed retrospectively. RESULTS: Nine separate bleeding episodes were treated with embolization (mean age, 56 years). This consisted of 6 patients who underwent primary angiographic embolization, with 3 patients requi...
15 CitationsSource
#1Shanmiao Gou (HUST: Huazhong University of Science and Technology)H-Index: 15
#2Zhiyong Yang (HUST: Huazhong University of Science and Technology)H-Index: 12
Last. Chunyou Wang (HUST: Huazhong University of Science and Technology)H-Index: 32
view all 5 authors...
Introduction Necrotic tissue infection can worsen the prognosis of severe acute pancreatitis (SAP), and probiotics have been shown to be beneficial in reducing the infection rate in animal experiments and primary clinical trials. However, the results of multicenter randomized clinical trials have been contradictory. Our aim in this study was to systematically review and quantitatively analyze all randomized controlled trials with regard to important outcomes in patients with predicted SAP who re...
49 CitationsSource
#1Gokhan Garip (Uludağ University)H-Index: 1
#2Emre SarandolH-Index: 23
Last. Ekrem KayaH-Index: 14
view all 3 authors...
Effects of disease severity and necrosis on pancreatic dysfunction after acute pancreatitis
23 CitationsSource
#1Raffaele Pezzilli (UNIBO: University of Bologna)H-Index: 54
#2Angelo Andriulli (UNIBO: University of Bologna)H-Index: 1
Last. Luca Frulloni (UNIBO: University of Bologna)H-Index: 11
view all 8 authors...
This is a medical position statement developed by the Exocrine Pancreatic Insufficiency collaborative group which is a part of the Italian Association for the Study of the Pancreas (AISP). We covered the main diseases associated with exocrine pancreatic insufficiency (EPI) which are of common interest to internists/gastroenterologists, oncologists and surgeons, fully aware that EPI may also occur together with many other diseases, but less frequently. A preliminary manuscript based on an extende...
68 CitationsSource
#1Jessalyn K. Holodinsky (U of C: University of Calgary)H-Index: 13
#2Derek J. Roberts (U of C: University of Calgary)H-Index: 39
Last. Andrew W. Kirkpatrick (FMC: Foothills Medical Centre)H-Index: 78
view all 10 authors...
Introduction Although intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are associated with substantial morbidity and mortality among critically ill adults, it remains unknown if prevention or treatment of these conditions improves patient outcomes. We sought to identify evidence-based risk factors for IAH and ACS in order to guide identification of the source population for future IAH/ACS treatment trials and to stratify patients into risk groups based on prognosis.
129 CitationsSource
Cited By61
Newest
#1Angela PhamH-Index: 1
#2Chris E. Forsmark (UF: University of Florida)H-Index: 49
view all 2 authors...
Source
#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
#1Kinji Furuya (University of Tsukuba)H-Index: 2
#2Tatsuya Oda (University of Tsukuba)H-Index: 38
Last. Shinji Hashimoto (University of Tsukuba)H-Index: 14
view all 16 authors...
Background Persistent pancreatic leakage (PL) due to disconnected pancreatic duct syndrome (DPDS) is associated with severe morbidity and mortality and it usually treated with internal drainage. However, in cases without localized fistula formation, internal drainage is challenging to perform. We report an original one-stage surgical approach for nonlocalized persistent PL, namely, the "intentional internal drainage tube method". Case presentation A 49-year-old woman whose main pancreatic duct w...
Source
#1Zhi Zheng (Capital Medical University)H-Index: 1
#2Yi-Xuan Ding (Capital Medical University)H-Index: 3
Last. Fei Li (Capital Medical University)H-Index: 10
view all 5 authors...
Acute pancreatitis (AP) is a common gastrointestinal disease with a high risk of mortality. Recently, the exosome and its potential regulatory role in the progression of AP has garnered the interest of researchers. However, effective drug interventions and therapeutic targets for AP remain to be established. Treatment approaches for AP have undergone considerable changes in the recent years: there is a greater preference for minimally invasive therapy (as primary treatment), multidisciplinary pa...
#1Caihong Ning (CSU: Central South University)H-Index: 3
#2Shuai Zhu (CSU: Central South University)H-Index: 1
Last. Gengwen Huang (CSU: Central South University)H-Index: 3
view all 11 authors...
BACKGROUND Intra-abdominal fungal infection (AFI) and candidemia are common in patients with acute pancreatitis (AP), but with limited and conflicting reports on their clinical impacts. This study aims to evaluate the clinical impacts of AFI and candidemia in infected pancreatic necrosis (IPN). METHODS A single-center, prospective cohort including 235 consecutive patients with IPN between January 2010 and September 2020 was analyzed to study the clinical impacts of AFI and candidemia. RESULTS Of...
Source
WHAT IS KNOWN AND OBJECTIVE Proton pump inhibitors (PPI) have become essential in the management of upper gastrointestinal disorders, yet they are prescribed without an indication in up to 89% of cases and the number of prescribed PPIs is on the rise. A working group developed several multifaceted strategies in our multihospital trust to curb inappropriate PPI use. We describe herein these strategies and assess their impact on PPI consumption in a hospital belonging to this trust. METHODS From 2...
Source
#1Claudio Ricci (UNIBO: University of Bologna)H-Index: 28
#2Nico PaganoH-Index: 20
Last. Riccardo CasadeiH-Index: 31
view all 8 authors...
OBJECTIVE: To evaluate all invasive treatments for suspected IPN. SUMMARY OF BACKGROUND DATA: The optimal invasive treatment for suspected IPN remains unclear. METHODS: A systematic search of randomized clinical trials comparing at least 2 invasive strategies for the treatment of suspected IPN was carried out. A frequentist random-effects network meta-analysis was made reporting the surface under the cumulative ranking (SUCRA). The primary endpoint regarded both the in-hospital mortality and maj...
Source
Diseases of the pancreas and hepatobiliary tree often require a therapeutic approach with endoscopic retrograde cholangiopancreatography (ERCP), generally following noninvasive imaging techniques. Appropriate indications and the correct timing for urgent ERCP would benefit both patients and clinicians and allow optimal utilization of health resources. Indications for urgent (<24 h) ERCP include severe acute cholangitis, acute biliary pancreatitis with cholangitis, biliary or pancreatic leaks, in...
Source
#1Dingcheng ShenH-Index: 3
Last. Gengwen Huang (CSU: Central South University)H-Index: 3
view all 4 authors...
BACKGROUND Various serum markers for early identification of severe acute pancreatitis (SAP) have been studied. Serum macrophage migration inhibitory factor (MIF) was reported to be correlated with severity of acute pancreatitis (AP) based on the 1992 Atlanta classification. However, MIF has never been proven to be predictive of disease severity based on the revised Atlanta classification (RAC). The potential predictive value of MIF needs to be further validated. METHODS Consecutive patients wit...
1 CitationsSource
ABSTRACT Acute respiratory distress syndrome (ARDS) is very common in patients with severe acute pancreatitis (SAP), the early interventions are essential to the prognosis of SAP patients. We aimed to evaluate the risk factors for ARDS in SAP patients, to provide insights into the management of SAP.SAP patients treated in our hospital from June 1, 2018 to May 31, 2020 were included. The characteristics and lab test results were collected and compared, and we conducted the logistic regression ana...
Source