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Published on: June 28, 2021
Prospective study of a protocol for selection of treatment of acute pancreatitis based on scoring of severity
H Yokoi1, T Naganuma, T Higashiguchi
1First Department of Surgery, Mie University School of Medicine, Mie, Japan.
Background/Aim:
Since July 1994, we have been conducting a prospective study of a protocol for selection of treatment of acute pancreatitis based on scoring of severity.
Methods:
From July 1994 to June 1998, 56 patients with acute pancreatitis were enrolled in this study. The protocol employed was based on the results of our retrospective study. On admission, the prognosis score (scoring of severity of acute pancreatitis based on the criteria of the Ministry of Health and Welfare of Japan) and APACHE II score were calculated, and early treatment was selected according to the protocol.
Results:
All of the 26 patients with gallstone pancreatitis and 28 of 30 patients with non-gallstone pancreatitis were successfully treated and had good outcome. There were 2 deaths in non-gallstone pancreatitis. In selection of early treatment according to the scoring of severity, we suggested that when the prognosis score is 2 or more and the APACHE II score of 8 or more, gallstone pancreatitis should be treated by biliary drainage, and non-gallstone pancreatitis by peritoneal lavage. When infected pancreatic necrosis is exhibited, surgery is indicated.
Conclusion:
Our new management protocol for acute pancreatitis based on the prognosis score and APACHE II score appear to be useful for accurately scoring severity and selecting the treatment methods.
Related Concept Videos
Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute Pancreatitis II: Clinical Manifestations and Management
Chronic Pancreatitis II: Collaborative Care
Assessment:
Acute Pancreatitis I: Introduction
Acute Pancreatitis II: Pathophysiology

