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. 2005 May;54(Suppl 3):iii1–iii9. doi: 10.1136/gut.2004.057026

UK guidelines for the management of acute pancreatitis

W UK
PMCID: PMC1867800  PMID: 15831893

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Selected References

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  1. Appelros S., Petersson U., Toh S., Johnson C., Borgström A. Activation peptide of carboxypeptidase B and anionic trypsinogen as early predictors of the severity of acute pancreatitis. Br J Surg. 2001 Feb;88(2):216–221. doi: 10.1046/j.1365-2168.2001.01672.x. [DOI] [PubMed] [Google Scholar]
  2. Balthazar E. J., Freeny P. C., vanSonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994 Nov;193(2):297–306. doi: 10.1148/radiology.193.2.7972730. [DOI] [PubMed] [Google Scholar]
  3. Balthazar Emil J. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology. 2002 Jun;223(3):603–613. doi: 10.1148/radiol.2233010680. [DOI] [PubMed] [Google Scholar]
  4. Bank S., Indaram A. Causes of acute and recurrent pancreatitis. Clinical considerations and clues to diagnosis. Gastroenterol Clin North Am. 1999 Sep;28(3):571-89, viii. doi: 10.1016/s0889-8553(05)70074-1. [DOI] [PubMed] [Google Scholar]
  5. Banks P. A., Gerzof S. G., Langevin R. E., Silverman S. G., Sica G. T., Hughes M. D. CT-guided aspiration of suspected pancreatic infection: bacteriology and clinical outcome. Int J Pancreatol. 1995 Dec;18(3):265–270. doi: 10.1007/BF02784951. [DOI] [PubMed] [Google Scholar]
  6. Beger H. G., Bittner R., Block S., Büchler M. Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology. 1986 Aug;91(2):433–438. doi: 10.1016/0016-5085(86)90579-2. [DOI] [PubMed] [Google Scholar]
  7. Bradley E. L., 3rd A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993 May;128(5):586–590. doi: 10.1001/archsurg.1993.01420170122019. [DOI] [PubMed] [Google Scholar]
  8. Brown Alphonso, Baillargeon Jean-Daniel, Hughes Michael D., Banks Peter A. Can fluid resuscitation prevent pancreatic necrosis in severe acute pancreatitis? Pancreatology. 2002;2(2):104–107. doi: 10.1159/000055899. [DOI] [PubMed] [Google Scholar]
  9. Buter A., Imrie C. W., Carter C. R., Evans S., McKay C. J. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis. Br J Surg. 2002 Mar;89(3):298–302. doi: 10.1046/j.0007-1323.2001.02025.x. [DOI] [PubMed] [Google Scholar]
  10. Büchler M. W., Gloor B., Müller C. A., Friess H., Seiler C. A., Uhl W. Acute necrotizing pancreatitis: treatment strategy according to the status of infection. Ann Surg. 2000 Nov;232(5):619–626. doi: 10.1097/00000658-200011000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Büchler M., Malfertheiner P., Uhl W., Schölmerich J., Stöckmann F., Adler G., Gaus W., Rolle K., Beger H. G. Gabexate mesilate in human acute pancreatitis. German Pancreatitis Study Group. Gastroenterology. 1993 Apr;104(4):1165–1170. doi: 10.1016/0016-5085(93)90288-n. [DOI] [PubMed] [Google Scholar]
  12. Canto M. I., Chak A., Stellato T., Sivak M. V., Jr Endoscopic ultrasonography versus cholangiography for the diagnosis of choledocholithiasis. Gastrointest Endosc. 1998 Jun;47(6):439–448. doi: 10.1016/s0016-5107(98)70242-1. [DOI] [PubMed] [Google Scholar]
  13. Carter C. R., McKay C. J., Imrie C. W. Percutaneous necrosectomy and sinus tract endoscopy in the management of infected pancreatic necrosis: an initial experience. Ann Surg. 2000 Aug;232(2):175–180. doi: 10.1097/00000658-200008000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Corfield A. P., Cooper M. J., Williamson R. C. Acute pancreatitis: a lethal disease of increasing incidence. Gut. 1985 Jul;26(7):724–729. doi: 10.1136/gut.26.7.724. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Delcenserie R., Yzet T., Ducroix J. P. Prophylactic antibiotics in treatment of severe acute alcoholic pancreatitis. Pancreas. 1996 Aug;13(2):198–201. [PubMed] [Google Scholar]
  16. Dellinger R. Phillip, Carlet Jean M., Masur Henry, Gerlach Herwig, Calandra Thierry, Cohen Jonathan, Gea-Banacloche Juan, Keh Didier, Marshall John C., Parker Margaret M. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004 Mar;32(3):858–873. doi: 10.1097/01.ccm.0000117317.18092.e4. [DOI] [PubMed] [Google Scholar]
  17. Dervenis C., Johnson C. D., Bassi C., Bradley E., Imrie C. W., McMahon M. J., Modlin I. Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference. Int J Pancreatol. 1999 Jun;25(3):195–210. doi: 10.1007/BF02925968. [DOI] [PubMed] [Google Scholar]
  18. Eatock F. C., Brombacher G. D., Steven A., Imrie C. W., McKay C. J., Carter R. Nasogastric feeding in severe acute pancreatitis may be practical and safe. Int J Pancreatol. 2000 Aug;28(1):23–29. doi: 10.1385/IJGC:28:1:23. [DOI] [PubMed] [Google Scholar]
  19. Fan S. T., Lai E. C., Mok F. P., Lo C. M., Zheng S. S., Wong J. Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med. 1993 Jan 28;328(4):228–232. doi: 10.1056/NEJM199301283280402. [DOI] [PubMed] [Google Scholar]
  20. Freeny P. C., Hauptmann E., Althaus S. J., Traverso L. W., Sinanan M. Percutaneous CT-guided catheter drainage of infected acute necrotizing pancreatitis: techniques and results. AJR Am J Roentgenol. 1998 Apr;170(4):969–975. doi: 10.2214/ajr.170.4.9530046. [DOI] [PubMed] [Google Scholar]
  21. Fölsch U. R., Nitsche R., Lüdtke R., Hilgers R. A., Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997 Jan 23;336(4):237–242. doi: 10.1056/NEJM199701233360401. [DOI] [PubMed] [Google Scholar]
  22. Gerzof S. G., Banks P. A., Robbins A. H., Johnson W. C., Spechler S. J., Wetzner S. M., Snider J. M., Langevin R. E., Jay M. E. Early diagnosis of pancreatic infection by computed tomography-guided aspiration. Gastroenterology. 1987 Dec;93(6):1315–1320. doi: 10.1016/0016-5085(87)90261-7. [DOI] [PubMed] [Google Scholar]
  23. Gupta R., Patel K., Calder P. C., Yaqoob P., Primrose J. N., Johnson C. D. A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic, inflammatory and oxidative markers in patients with predicted severe acute pancreatitis (APACHE II > or =6). Pancreatology. 2003 Sep 24;3(5):406–413. doi: 10.1159/000073657. [DOI] [PubMed] [Google Scholar]
  24. Halvorsen F. A., Ritland S. Acute pancreatitis in Buskerud County, Norway. Incidence and etiology. Scand J Gastroenterol. 1996 Apr;31(4):411–414. doi: 10.3109/00365529609006419. [DOI] [PubMed] [Google Scholar]
  25. Hogan W. J., Sherman S., Pasricha P., Carr-Locke D. Sphincter of Oddi manometry. Gastrointest Endosc. 1997 Mar;45(3):342–348. [PubMed] [Google Scholar]
  26. Isenmann R., Rau B., Beger H. G. Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis. Br J Surg. 1999 Aug;86(8):1020–1024. doi: 10.1046/j.1365-2168.1999.01176.x. [DOI] [PubMed] [Google Scholar]
  27. Isenmann Rainer, Rünzi Michael, Kron Martina, Kahl Stefan, Kraus Dietmar, Jung Norbert, Maier Ludwig, Malfertheiner Peter, Goebell Harald, Beger Hans G. Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial. Gastroenterology. 2004 Apr;126(4):997–1004. doi: 10.1053/j.gastro.2003.12.050. [DOI] [PubMed] [Google Scholar]
  28. Johnson C. D. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. BMJ. 2001 Nov 17;323(7322):1170–1173. doi: 10.1136/bmj.323.7322.1170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Johnson C. D., Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004 Sep;53(9):1340–1344. doi: 10.1136/gut.2004.039883. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Johnson C. D., Kingsnorth A. N., Imrie C. W., McMahon M. J., Neoptolemos J. P., McKay C., Toh S. K., Skaife P., Leeder P. C., Wilson P. Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis. Gut. 2001 Jan;48(1):62–69. doi: 10.1136/gut.48.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Johnson C. D. Timing of intervention in acute pancreatitis. Postgrad Med J. 1993 Jul;69(813):509–515. doi: 10.1136/pgmj.69.813.509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Kalfarentzos F., Kehagias J., Mead N., Kokkinis K., Gogos C. A. Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomized prospective trial. Br J Surg. 1997 Dec;84(12):1665–1669. [PubMed] [Google Scholar]
  33. Kemppainen E., Sainio V., Haapiainen R., Kivisaari L., Kivilaakso E., Puolakkainen P. Early localization of necrosis by contrast-enhanced computed tomography can predict outcome in severe acute pancreatitis. Br J Surg. 1996 Jul;83(7):924–929. doi: 10.1002/bjs.1800830713. [DOI] [PubMed] [Google Scholar]
  34. King N. K. K., Powell J. J., Redhead D., Siriwardena A. K. A simplified method for computed tomographic estimation of prognosis in acute pancreatitis. Scand J Gastroenterol. 2003 Apr;38(4):433–436. doi: 10.1080/00365520310000915. [DOI] [PubMed] [Google Scholar]
  35. Lankisch P. G., Assmus C., Pflichthofer D. The clock and acute pancreatitis. Int J Pancreatol. 1997 Dec;22(3):235–236. doi: 10.1007/BF02788391. [DOI] [PubMed] [Google Scholar]
  36. Luiten E. J., Hop W. C., Lange J. F., Bruining H. A. Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis. Ann Surg. 1995 Jul;222(1):57–65. doi: 10.1097/00000658-199507000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Maes B., Hastier P., Buckley M. J., Peten E. P., Paolini O., Staccini P., Conio M., Caroli-Bosc F. X., Demarquay J. F., Dumas R. Extensive aetiological investigations in acute pancreatitis: results of a 1-year prospective study. Eur J Gastroenterol Hepatol. 1999 Aug;11(8):891–896. [PubMed] [Google Scholar]
  38. McKay A. J., Imrie C. W., O'Neill J., Duncan J. G. Is an early ultrasound scan of value in acute pancreatitis? Br J Surg. 1982 Jul;69(7):369–372. doi: 10.1002/bjs.1800690704. [DOI] [PubMed] [Google Scholar]
  39. McKay C. J., Evans S., Sinclair M., Carter C. R., Imrie C. W. High early mortality rate from acute pancreatitis in Scotland, 1984-1995. Br J Surg. 1999 Oct;86(10):1302–1305. doi: 10.1046/j.1365-2168.1999.01246.x. [DOI] [PubMed] [Google Scholar]
  40. Mithöfer K., Mueller P. R., Warshaw A. L. Interventional and surgical treatment of pancreatic abscess. World J Surg. 1997 Feb;21(2):162–168. doi: 10.1007/s002689900209. [DOI] [PubMed] [Google Scholar]
  41. Neoptolemos J. P., Carr-Locke D. L., London N. J., Bailey I. A., James D., Fossard D. P. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet. 1988 Oct 29;2(8618):979–983. doi: 10.1016/s0140-6736(88)90740-4. [DOI] [PubMed] [Google Scholar]
  42. Neoptolemos J. P., Kemppainen E. A., Mayer J. M., Fitzpatrick J. M., Raraty M. G., Slavin J., Beger H. G., Hietaranta A. J., Puolakkainen P. A. Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide: a multicentre study. Lancet. 2000 Jun 3;355(9219):1955–1960. doi: 10.1016/s0140-6736(00)02327-8. [DOI] [PubMed] [Google Scholar]
  43. Nordback I., Sand J., Saaristo R., Paajanen H. Early treatment with antibiotics reduces the need for surgery in acute necrotizing pancreatitis--a single-center randomized study. J Gastrointest Surg. 2001 Mar-Apr;5(2):113–120. doi: 10.1016/s1091-255x(01)80021-4. [DOI] [PubMed] [Google Scholar]
  44. Pederzoli P., Bassi C., Vesentini S., Campedelli A. A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet. 1993 May;176(5):480–483. [PubMed] [Google Scholar]
  45. Powell J. J., Murchison J. T., Fearon K. C., Ross J. A., Siriwardena A. K. Randomized controlled trial of the effect of early enteral nutrition on markers of the inflammatory response in predicted severe acute pancreatitis. Br J Surg. 2000 Oct;87(10):1375–1381. doi: 10.1046/j.1365-2168.2000.01558.x. [DOI] [PubMed] [Google Scholar]
  46. Rau B., Cebulla M., Uhl W., Schoenberg M. H., Beger H. G. The clinical value of human pancreas-specific protein procarboxypeptidase B as an indicator of necrosis in acute pancreatitis: comparison to CRP and LDH. Pancreas. 1998 Aug;17(2):134–139. doi: 10.1097/00006676-199808000-00004. [DOI] [PubMed] [Google Scholar]
  47. Rau B., Pralle U., Mayer J. M., Beger H. G. Role of ultrasonographically guided fine-needle aspiration cytology in the diagnosis of infected pancreatic necrosis. Br J Surg. 1998 Feb;85(2):179–184. doi: 10.1046/j.1365-2168.1998.00707.x. [DOI] [PubMed] [Google Scholar]
  48. Sainio V., Kemppainen E., Puolakkainen P., Taavitsainen M., Kivisaari L., Valtonen V., Haapiainen R., Schröder T., Kivilaakso E. Early antibiotic treatment in acute necrotising pancreatitis. Lancet. 1995 Sep 9;346(8976):663–667. doi: 10.1016/s0140-6736(95)92280-6. [DOI] [PubMed] [Google Scholar]
  49. Schwarz M., Isenmann R., Meyer H., Beger H. G. Antibiotika bei nekrotisierender Pankreatitis. Ergebnisse einer kontrollierten Studie. Dtsch Med Wochenschr. 1997 Mar 21;122(12):356–361. doi: 10.1055/s-2008-1047621. [DOI] [PubMed] [Google Scholar]
  50. Teerenhovi O., Nordback I., Eskola J. High volume lesser sac lavage in acute necrotizing pancreatitis. Br J Surg. 1989 Apr;76(4):370–373. doi: 10.1002/bjs.1800760418. [DOI] [PubMed] [Google Scholar]
  51. Tenner S., Fernandez-del Castillo C., Warshaw A., Steinberg W., Hermon-Taylor J., Valenzuela J. E., Hariri M., Hughes M., Banks P. A. Urinary trypsinogen activation peptide (TAP) predicts severity in patients with acute pancreatitis. Int J Pancreatol. 1997 Apr;21(2):105–110. doi: 10.1007/BF02822381. [DOI] [PubMed] [Google Scholar]
  52. Toh S. K., Phillips S., Johnson C. D. A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England. Gut. 2000 Feb;46(2):239–243. doi: 10.1136/gut.46.2.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  53. Uhl W., Büchler M. W., Malfertheiner P., Beger H. G., Adler G., Gaus W. A randomised, double blind, multicentre trial of octreotide in moderate to severe acute pancreatitis. Gut. 1999 Jul;45(1):97–104. doi: 10.1136/gut.45.1.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Uhl Waldemar, Roggo Antoine, Kirschstein Timo, Anghelacopoulos S. E., Gloor Beat, Müller Christophe A., Malfertheiner Peter, Büchler Markus W. Influence of contrast-enhanced computed tomography on course and outcome in patients with acute pancreatitis. Pancreas. 2002 Mar;24(2):191–197. doi: 10.1097/00006676-200203000-00011. [DOI] [PubMed] [Google Scholar]
  55. Uhl Waldemar, Warshaw Andrew, Imrie Clement, Bassi Claudio, McKay Colin J., Lankisch Paul G., Carter Ross, Di Magno Eugene, Banks Peter A., Whitcomb David C. IAP Guidelines for the Surgical Management of Acute Pancreatitis. Pancreatology. 2002;2(6):565–573. doi: 10.1159/000071269. [DOI] [PubMed] [Google Scholar]
  56. Windsor A. C., Kanwar S., Li A. G., Barnes E., Guthrie J. A., Spark J. I., Welsh F., Guillou P. J., Reynolds J. V. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis. Gut. 1998 Mar;42(3):431–435. doi: 10.1136/gut.42.3.431. [DOI] [PMC free article] [PubMed] [Google Scholar]

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