IAP/APA evidence-based guidelines for the management of acute pancreatitis
Working Group IAP/APA Acute Pancreatitis Guidelines, Marc Besselink, Hjalmar van Santvoort, Martin Freeman, Timothy Gardner, Julia Mayerle, Santhi Swaroop Vege, Jens Werner, Peter Banks, Colin McKay, Carlos Fernandez-del Castillo, Jeremy French, Hein Gooszen, Colin Johnson, Mike Sarr, Tadahiro Takada, John Windsor, Ashok Saluja, Rodger Liddle, Georgios Papachristou, Vijay Singh, Michael Rünzi, Julia Mayerle, Bechien Wu, Vikesh Singh, John Windsor, Peter Banks, Georgios Papachristou, Thomas Bollen, Desiree Morgan, Koenraad Mortele, Anubhav Mittal, John Windsor, Mao En-qiang, Timothy Gardner, Julia Mayerle, Julia Mayerle, Colin Johnson, Jan de Waele, Hjalmar van Santvoort, Maxim Petrov, Patchen Dellinger, Marc Besselink, Markus M Lerch, Timothy Gardner, Maxim Petrov, Roland Anderson, Stephen McClave, Timothy Gardner, Werner Hartwig, Hjalmar van Santvoort, Martin Freeman, Marco Bruno, Alejandro Oria, Peter Banks, Julia Mayerle, Marc Besselink, Timothy Gardner, Hein Gooszen, Todd Baron, Carlos Fernandez-del Castillo, Jens Werner, Peter Fagenholz, Marc Besselink, Hjalmar van Santvoort, Todd Baron, Karen Horvath, Thomas Bollen, Koenraad Mortele, Jens Werner, Martin Freeman, Mark van Baal, William Nealon, Timothy Gardner, Julia Mayerle, Ake Andren-Sandberg, Olaf Bakker, Claudio Bassi, Markus Buchler, Marja Boermeester, Ed Bradley, Suresh Chari, Richard Charnley, Saxon Connor, Christos Dervenis, Jacques Deviere, Vikas Dudeja, Paul Fockens, Chris Forsmark, Helmut Friess, Shuji Isaji, Rainer Isenmann, Ernst Klar, Philippe Lévy, Keith Lillemoe, Xubao Liu, Chengdu Matthias Löhr, Toshihiko Mayumi, Joachim Mossner, John Neoptolemos, Isto Nordback, Attila Olah, Roy Padbury, Rowan Parks, Dejan Radenkovic, Bettina Rau, Vinciane Rebours, Stefan Seewald, Hans Seifert, Tooru Shimosegawa, Ajith Siriwardena, William Steinberg, Robert Sutton, Masao Tanaka, Kazunori Takeda, Francis Tse, Harry van Goor, Andrew Warshaw, Chunyou Wang, David Whitcomb, Yupei Zhao, Nicholas Zyromski, Working Group IAP/APA Acute Pancreatitis Guidelines, Marc Besselink, Hjalmar van Santvoort, Martin Freeman, Timothy Gardner, Julia Mayerle, Santhi Swaroop Vege, Jens Werner, Peter Banks, Colin McKay, Carlos Fernandez-del Castillo, Jeremy French, Hein Gooszen, Colin Johnson, Mike Sarr, Tadahiro Takada, John Windsor, Ashok Saluja, Rodger Liddle, Georgios Papachristou, Vijay Singh, Michael Rünzi, Julia Mayerle, Bechien Wu, Vikesh Singh, John Windsor, Peter Banks, Georgios Papachristou, Thomas Bollen, Desiree Morgan, Koenraad Mortele, Anubhav Mittal, John Windsor, Mao En-qiang, Timothy Gardner, Julia Mayerle, Julia Mayerle, Colin Johnson, Jan de Waele, Hjalmar van Santvoort, Maxim Petrov, Patchen Dellinger, Marc Besselink, Markus M Lerch, Timothy Gardner, Maxim Petrov, Roland Anderson, Stephen McClave, Timothy Gardner, Werner Hartwig, Hjalmar van Santvoort, Martin Freeman, Marco Bruno, Alejandro Oria, Peter Banks, Julia Mayerle, Marc Besselink, Timothy Gardner, Hein Gooszen, Todd Baron, Carlos Fernandez-del Castillo, Jens Werner, Peter Fagenholz, Marc Besselink, Hjalmar van Santvoort, Todd Baron, Karen Horvath, Thomas Bollen, Koenraad Mortele, Jens Werner, Martin Freeman, Mark van Baal, William Nealon, Timothy Gardner, Julia Mayerle, Ake Andren-Sandberg, Olaf Bakker, Claudio Bassi, Markus Buchler, Marja Boermeester, Ed Bradley, Suresh Chari, Richard Charnley, Saxon Connor, Christos Dervenis, Jacques Deviere, Vikas Dudeja, Paul Fockens, Chris Forsmark, Helmut Friess, Shuji Isaji, Rainer Isenmann, Ernst Klar, Philippe Lévy, Keith Lillemoe, Xubao Liu, Chengdu Matthias Löhr, Toshihiko Mayumi, Joachim Mossner, John Neoptolemos, Isto Nordback, Attila Olah, Roy Padbury, Rowan Parks, Dejan Radenkovic, Bettina Rau, Vinciane Rebours, Stefan Seewald, Hans Seifert, Tooru Shimosegawa, Ajith Siriwardena, William Steinberg, Robert Sutton, Masao Tanaka, Kazunori Takeda, Francis Tse, Harry van Goor, Andrew Warshaw, Chunyou Wang, David Whitcomb, Yupei Zhao, Nicholas Zyromski
Abstract
Background: There have been substantial improvements in the management of acute pancreatitis since the publication of the International Association of Pancreatology (IAP) treatment guidelines in 2002. A collaboration of the IAP and the American Pancreatic Association (APA) was undertaken to revise these guidelines using an evidence-based approach.
Methods: Twelve multidisciplinary review groups performed systematic literature reviews to answer 38 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The review groups presented their recommendations during the 2012 joint IAP/APA meeting. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting.
Results: The 38 recommendations covered 12 topics related to the clinical management of acute pancreatitis: A) diagnosis of acute pancreatitis and etiology, B) prognostication/predicting severity, C) imaging, D) fluid therapy, E) intensive care management, F) preventing infectious complications, G) nutritional support, H) biliary tract management, I) indications for intervention in necrotizing pancreatitis, J) timing of intervention in necrotizing pancreatitis, K) intervention strategies in necrotizing pancreatitis, and L) timing of cholecystectomy. Using the GRADE system, 21 of the 38 (55%) recommendations, were rated as 'strong' and plenary voting revealed 'strong agreement' for 34 (89%) recommendations.
Conclusions: The 2012 IAP/APA guidelines provide recommendations concerning key aspects of medical and surgical management of acute pancreatitis based on the currently available evidence. These recommendations should serve as a reference standard for current management and guide future clinical research on acute pancreatitis.
Keywords: Acute pancreatitis; Diagnosis; Gastroenterology; Guidelines; Intervention; Nutrition; Pancreas; Prediction; Prevention; Radiology; Surgery; Treatment.
Copyright © 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Source: PubMed