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Early management of acute pancreatitis

Nicolien J Schepers1, Marc G H Besselink, Hjalmar C van Santvoort

  • 1Department of Operation Rooms, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands.

Best Practice & Research. Clinical Gastroenterology
|October 29, 2013
PubMed

Insights

Acute pancreatitis is a common cause of hospitalization with rising incidence. Early management of fluid therapy, nutrition, and interventions like ERCP is crucial for severe cases to prevent organ failure and infections.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Critical Care Medicine

Background:

  • Acute pancreatitis is the leading gastrointestinal cause of hospital admission, with increasing prevalence.
  • Severe acute pancreatitis is associated with high morbidity and mortality, primarily due to organ failure and secondary infections.

Purpose of the Study:

  • To review the initial management strategies for acute pancreatitis within the first hours to days of symptom onset.
  • To discuss the revised Atlanta classification for standardized communication of pancreatitis severity and complications.

Main Methods:

  • Literature review focusing on early management of acute pancreatitis.
  • Discussion of key interventions including fluid resuscitation, nutritional support, and endoscopic retrograde cholangiography (ERCP).
  • Analysis of the updated Atlanta classification criteria.

Main Results:

  • Early fluid therapy, appropriate nutrition, and timely ERCP are critical in managing acute pancreatitis.
  • The revised Atlanta classification offers a standardized framework for classifying pancreatitis severity and complications.
  • Effective early management can mitigate organ failure and infectious complications.

Conclusions:

  • Optimizing early management of acute pancreatitis is essential for improving patient outcomes.
  • Standardized classification systems like the revised Atlanta criteria enhance clinical communication and research.
  • Focus on preventing organ failure and infections is paramount in severe acute pancreatitis.

Keywords:
ACSCARSCBDCECTDiagnosisERCERCPEUSHESICUIDUSMRCPMRIPancreasPancreatitisReviewSIRSTreatmentabdominal compartment syndromecommon bile ductcompensatory anti-inflammatory response syndromecontrast-enhanced computed tomographyendoscopic retrograde cholangiographyendoscopic retrograde cholangiopancreatographyendoscopic ultrasoundhydroxyethyl starchintensive care unitintraductal ultrasoundmagnetic resonance cholangiopancreatographymagnetic resonance imagingsystemic inflammatory response syndrome

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