Advances in Management of Acute Pancreatitis

Gastroenterol Clin North Am. 2016 Mar;45(1):1-8. doi: 10.1016/j.gtc.2015.10.004. Epub 2015 Dec 19.

Abstract

This article reviews advances in the management of acute pancreatitis. Medical treatment has been primarily supportive for this diagnosis, and despite extensive research efforts, there are no pharmacologic therapies that improve prognosis. The current mainstay of management, notwithstanding the ongoing debate regarding the volume, fluid type, and rate of administration, is aggressive intravenous fluid resuscitation. Although antibiotics were used consistently for prophylaxis in severe acute pancreatitis to prevent infection, they are no longer used unless infection is documented. Enteral nutrition, especially in patients with severe acute pancreatitis, is considered a cornerstone in management of this disease.

Keywords: Acute pancreatitis; Antibiotics; Bedside Index for Severity in Acute Pancreatitis; Fluid resuscitation; Medical management; Prognostication; Walled-off pancreatic necrosis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholangitis / complications
  • Cholangitis / therapy*
  • Cholecystectomy
  • Enteral Nutrition
  • Fluid Therapy / methods*
  • Gallstones / complications
  • Gallstones / surgery*
  • Humans
  • Isotonic Solutions / therapeutic use
  • Pancreatitis / etiology
  • Pancreatitis / therapy*
  • Practice Guidelines as Topic
  • Ringer's Lactate

Substances

  • Isotonic Solutions
  • Ringer's Lactate