The DOI matches its Crossref record; 163 of the 164 references it cites were found in a registry or an index.
American College of Gastroenterology Guideline: Management of Acute Pancreatitis
Abstract
This guideline presents recommendations for the management of patients with acute pancreatitis (AP). During the past decade, there have been new understandings and developments in the diagnosis, etiology, and early and late management of the disease. As the diagnosis of AP is most often established by clinical symptoms and laboratory testing, contrast-enhanced computed tomography (CECT) and/or magnetic resonance imaging (MRI) of the pancreas should be reserved for patients in whom the diagnosis is unclear or who fail to improve clinically. Hemodynamic status should be assessed immediately upon presentation and resuscitative measures begun as needed. Patients with organ failure and/or the systemic inflammatory response syndrome (SIRS) should be admitted to an intensive care unit or intermediary care setting whenever possible. Aggressive hydration should be provided to all patients, unless cardiovascular and/or renal comorbidites preclude it. Early aggressive intravenous hydration is most beneficial within the first 12-24 h, and may have little benefit beyond. Patients with AP and concurrent acute cholangitis should undergo endoscopic retrograde cholangiopancreatography (ERCP) within 24 h of admission. Pancreatic duct stents and/or postprocedure rectal nonsteroidal anti-inflammatory drug (NSAID) suppositories should be utilized to lower the risk of severe post-ERCP pancreatitis in high-risk patients. Routine use of prophylactic antibiotics in patients with severe AP and/or sterile necrosis is not recommended. In patients with infected necrosis, antibiotics known to penetrate pancreatic necrosis may be useful in delaying intervention, thus decreasing morbidity and mortality. In mild AP, oral feedings can be started immediately if there is no nausea and vomiting. In severe AP, enteral nutrition is recommended to prevent infectious complications, whereas parenteral nutrition should be avoided. Asymptomatic pancreatic and/or extrapancreatic necrosis and/or pseudocysts do not warrant intervention regardless of size, location, and/or extension. In stable patients with infected necrosis, surgical, radiologic, and/or endoscopic drainage should be delayed, preferably for 4 weeks, to allow the development of a wall around the necrosis.
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“EN is beneficial and early oral feeding with hospital food is not recommended”
From ESPEN guideline on hospital nutrition (2021) · cites this paper as [205]
In the citing paper
“During attacks of acute pancreatitis, early aggressive IV hydration with 250 to 500 mL/h may prevent intravascular volume depletion and pancreatic necrosis.50,51”
From Familial chylomicronemia syndrome: Bringing to life dietary recommendations throughout the life span (2018) · cites this paper as [50]
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“Severe acute pancreatitis is defined by persistent organ failure lasting >48 hours from admission.(332) Previous scoring systems also used the presence of unfavorable prognostic signs (APACHE II score ≥8 [Acute Physiology and Chronic Health Assessment II], Ranson criteria >3, and CRP level >150 mg/L) to identify patie…”
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Metadata
- Authors
- Tenner, S., Baillie, J., DeWitt, J., & Vege, S. S.
- Affiliations
- SUNY Downstate Health Sciences University (US)
- Carteret General Hospital (US)
- Mayo Clinic (US)
- Corresponding author
- Vege, Santhi Swaroop
- Venue
- American Journal of Gastroenterology
- Published
- 2013-09
- Volume
- 108
- Issue
- 9
- Pages
- 1400-1415
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W1972516036
- Semantic Scholar
- 47448440997e168032405b8c54dc2587912c980b
- Cited by
- 2,327
- References
- 164
- Citations by year
- 2026: 110 · 2025: 117 · 2024: 179 · 2023: 256 · 2022: 250 · 2021: 244 · 2020: 220 · 2019: 191 · 2018: 192 · 2017: 175 · 2016: 144 · 2015: 159 · 2014: 82 · 2013: 3
- FWCI
- 125.98
- Type
- journal article
- Language
- en
- Update notices
- erratum (2014-02-05)
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Gastroenterology › Gallbladder and Bile Duct Disorders
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- acute pancreatitis, contrast-enhanced CT, hemodynamic resuscitation, systemic inflammatory response syndrome, intensive care unit admission, intravenous hydration, acute cholangitis, endoscopic retrograde cholangiopancreatography, post-ERCP pancreatitis, pancreatic stent, antibiotic prophylaxis, infected pancreatic necrosis, sterile pancreatic necrosis, enteral nutrition, parenteral nutrition, pancreatic pseudocyst
- MeSH terms
- Acute Disease, Cholangiopancreatography, Endoscopic Retrograde, Drainage, Gastroenterology, Humans, Pancreas, Pancreatic Ducts, Pancreatitis, Prognosis
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