08 Mar IAP & APA evidence based guidelines for the management of acute pancreatitis

Abstract:
Background: since the International Association of pancreatic diseases (IAP) guidelines were published in 2002, there have been many substantial improvements. Therefore, IAP and the American pancreatic Association (APA) jointly revised these guidelines through consultation.

Methods: Thirty eight pre selected clinical problems were suggested by 12 multidisciplinary review groups through systematic literature review. The grading of recommendations assessment, development and evaluation (grade) is adopted for each proposal. At the IAP / APA joint meeting in 2012, the groups submitted suggestions. All members voted on each proposal and conducted relevant comments and comprehensive consultations.

Results: the 38 recommendations covered 12 clinical topics of acute pancreatitis: a) diagnosis and etiology of acute pancreatitis; b) prediction of severity; c) imaging examination; d) fluid therapy; E) intensive care measures; F) prevention of infection complications; g) nutritional support; H) biliary tract management; I) indication of necrotizing pancreatitis (NP) intervention; J) timing of NP intervention; K) strategy of NP intervention; and C) strategy of NP intervention; 50) Timing of cholecystectomy. Among the 38 recommendations, 21 were rated as strong recommendations by the grade system, and the voting results of 34 showed that they reached a high degree of consensus.

Conclusion: the 2012 IAP / APA guidelines provide recommendations on key aspects of surgical and surgical treatment of acute pancreatitis based on recent available evidence. These recommendations should be used as reference standards for current treatment and guidelines for future clinical studies of acute pancreatitis.