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Establishment of a Mouse Severe Acute Pancreatitis Model using Retrograde Injection of Sodium Taurocholate into the Biliopancreatic Duct
Published on: April 1, 2022
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[Acute pancreatitis: Progress through Restraint?]
Jonathan Frederik Brozat1, Frank Tacke1
1Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campi CCM und CVK, Berlin, Deutschland.
Deutsche Medizinische Wochenschrift (1946)
|August 7, 2025
Summary
Acute pancreatitis management emphasizes a step-up approach, prioritizing early nutrition and fluids. Antibiotic prophylaxis is not recommended, and minimally invasive techniques are preferred for infected necrosis.
Area of Science:
- Gastroenterology and Hepatology
- Critical Care Medicine
Context:
- Acute pancreatitis (AP) is a severe condition with initial sterile inflammation potentially progressing to infected necrosis.
- Management has evolved towards a minimally invasive, step-up strategy.
Purpose:
- To outline current best practices for diagnosing and managing acute pancreatitis.
- To emphasize evidence-based guidelines for fluid resuscitation, nutrition, and treatment of necrosis.
Summary:
- Diagnosis relies on pain, elevated lipase, or imaging; amylase is not essential. Delayed contrast-enhanced CT (≥72h) is recommended unless necrosis is suspected.
- Early goal-directed fluid resuscitation with balanced crystalloids and early enteral/oral nutrition (within 24h) are crucial. Opioids are first-line for pain relief.
- Antibiotic prophylaxis is not advised. Infected necrosis management is stepwise: antibiotics, drainage, followed by delayed minimally invasive necrosectomy, preferably endoscopic.
Impact:
- Adherence to these guidelines can improve patient outcomes and reduce complications like infected necrosis.
- Specialized centers with multidisciplinary expertise demonstrate significantly better results in managing severe AP.
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