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Recent advances in understanding and managing acute pancreatitis
This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority o...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
F1000 Research Limited
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039949/ https://www.ncbi.nlm.nih.gov/pubmed/30026919 http://dx.doi.org/10.12688/f1000research.14244.2 |
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author | Mandalia, Amar Wamsteker, Erik-Jan DiMagno, Matthew J. |
author_facet | Mandalia, Amar Wamsteker, Erik-Jan DiMagno, Matthew J. |
author_sort | Mandalia, Amar |
collection | PubMed |
description | This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research. |
format | Online Article Text |
id | pubmed-6039949 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | F1000 Research Limited |
record_format | MEDLINE/PubMed |
spelling | pubmed-60399492018-07-18 Recent advances in understanding and managing acute pancreatitis Mandalia, Amar Wamsteker, Erik-Jan DiMagno, Matthew J. F1000Res Review This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research. F1000 Research Limited 2019-01-10 /pmc/articles/PMC6039949/ /pubmed/30026919 http://dx.doi.org/10.12688/f1000research.14244.2 Text en Copyright: © 2019 Mandalia A et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Mandalia, Amar Wamsteker, Erik-Jan DiMagno, Matthew J. Recent advances in understanding and managing acute pancreatitis |
title | Recent advances in understanding and managing acute pancreatitis |
title_full | Recent advances in understanding and managing acute pancreatitis |
title_fullStr | Recent advances in understanding and managing acute pancreatitis |
title_full_unstemmed | Recent advances in understanding and managing acute pancreatitis |
title_short | Recent advances in understanding and managing acute pancreatitis |
title_sort | recent advances in understanding and managing acute pancreatitis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039949/ https://www.ncbi.nlm.nih.gov/pubmed/30026919 http://dx.doi.org/10.12688/f1000research.14244.2 |
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