Elsevier

Pancreatology

Volume 13, Issue 4, Supplement 2, July–August 2013, Pages e1-e15
Pancreatology

Original article
IAP/APA evidence-based guidelines for the management of acute pancreatitis

https://doi.org/10.1016/j.pan.2013.07.063Get rights and content
Under a Creative Commons license
open access

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
Pancreas
Guidelines
Diagnosis
Prediction
Prevention
Treatment
Intervention
Nutrition
Surgery
Radiology
Gastroenterology

Cited by (0)

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

1

See Collaborator section ([email protected]).