Diagnosis and Treatment of Acute Pancreatitis

Abstract

The pancreas is a glandular organ that is responsible for the proper functioning of the digestive and endocrine systems, and therefore, it affects the condition of the entire body. Consequently, it is important to effectively diagnose and treat diseases of this organ. According to clinicians, pancreatitis—a common disease affecting the pancreas—is one of the most complicated and demanding diseases of the abdomen. The classification of pancreatitis is based on clinical, morphologic, and histologic criteria. Medical doctors distinguish, inter alia, acute pancreatitis (AP), the most common causes of which are gallstone migration and alcohol abuse. Effective diagnostic methods and the correct assessment of the severity of acute pancreatitis determine the selection of an appropriate treatment strategy and the prediction of the clinical course of the disease, thus preventing life-threatening complications and organ dysfunction or failure. This review collects and organizes recommendations and guidelines for the management of patients suffering from acute pancreatitis.

Point-of-Care Tests for Pancreatitis

“…24,26 However, this modality is limited for routine screening due to its high costs, wait time for results, limited availability, exposure to ionizing radiation, and other potential adverse events. 3,27 What Is the Evidence?…”

The Role of MicroRNAs in Pancreatitis Development and Progression

“…Both types of pancreatitis lead to impaired critical endocrine and exocrine functions; however, they are identified by distinct diagnostic criteria. Acute pancreatitis (AP) is diagnosed when the patient presents with persistent abdominal pain, specifically epigastric pain, levels of serum amylase and lipase greater than three times the upper limit of the normal value, and identification via ultrasound, contrast-enhanced computed tomography, or magnetic resonance imaging (MRI) [ 7 , 8 , 9 , 10 ]. In contrast, CP diagnosis relies on identification using MRI with magnetic resonance cholangiopancreatography coupled with intravenously delivered secretin to detect changes in ductal morphology and assess any functional abnormalities.…”

Pancreatic Necrosis Infection as a Determinant of Multiple Organ Failure and Mortality in Acute Pancreatitis

“…In different periods, the treatment of AP has changed from being strictly conservative to the use of various methods of surgical treatment [ 5 , 6 ]. Modern surgical tactics for the treatment of local complications of ANP are based on the widespread implementation of minimally invasive procedures (MIP) [ 6 , 7 ], and the world community of pancreatologists has initiated the introduction of a step-up approach tactic to the surgical clinic, and includes percutaneous drainage, transluminal endoscopic necrosectomy through the stomach or duodenum, laparoscopic necrosectomy, retroperitoneal surgical drainage, etc.…”

“…In different periods, the treatment of AP has changed from being strictly conservative to the use of various methods of surgical treatment [ 5 , 6 ]. Modern surgical tactics for the treatment of local complications of ANP are based on the widespread implementation of minimally invasive procedures (MIP) [ 6 , 7 ], and the world community of pancreatologists has initiated the introduction of a step-up approach tactic to the surgical clinic, and includes percutaneous drainage, transluminal endoscopic necrosectomy through the stomach or duodenum, laparoscopic necrosectomy, retroperitoneal surgical drainage, etc. [ 8 ], as independent surgical methods of treatment in the presence of pancreatic and peripancreatic accumulation of fluid formations and pseudocysts, or as a sequential staged approach (step-up approach) of preparation for necrosectomy in the case of infection, which is consistent with the principles of international recommendations [ 9 , 10 ].…”