Management of biliary acute pancreatitis

Bougard, M.; Barbier, Louise; Godart, Bruno; Bayon-Bréard, A.-G. Le; Marques, F.; Salamé, Ephrem

doi:10.1016/j.jviscsurg.2018.08.002

Cited by 28 publications

(42 citation statements)

References 57 publications

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“…Early surgical intervention in biliary pancreatitis drastically reduces mortality and gallstones related complications[103]. In addition, patients with moderately severe and severe AP should undergo an interval cholecystectomy after discharge[104]. Overall, cholecystectomy in patients with gallstone related pancreatitis have been shown to drastically reduce the incidence of recurrent AP[9].…”

Section: Managementmentioning

confidence: 99%

Evaluation and management of acute pancreatitis

Chatila

Bilal

Guturu

2019

WJCC

114

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Acute pancreatitis (AP) is one of the most common gastrointestinal causes for hospi-talization in the United States. In 2015, AP accounted for approximately 390000 hospitalizations. The burden of AP is only expected to increase over time. Despite recent advances in medicine, pancreatitis continues to be associated with a substantial morbidity and mortality. The most common cause of AP is gallstones, followed closely by alcohol use. The diagnosis of pancreatitis is established with any two of three following criteria: (1) Abdominal pain consistent with that of AP; (2) Serum amylase and/or lipase greater than three times the upper limit of normal; and (3) Characteristics findings seen in cross-sectional abdominal imaging. Multiple criteria and scoring systems have been established for assessing severity of AP. The cornerstones of management include aggressive intravenous hydration, appropriate nutrition and pain management. Endoscopic retrograde cholangiopancreatography and surgery are important aspects in management of acute gallstone pancreatitis. We provide a comprehensive review of evaluation and management of AP.

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Section: Managementmentioning

confidence: 99%

Evaluation and management of acute pancreatitis

Chatila

Bilal

Guturu

2019

WJCC

114

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“…Although there is no universally accepted treatment approach for SABP, the step-up approach using endoscopic drainage or percutaneous has been demonstrated to produce superior outcomes [37] . First, the 2019 Guidelines for management of acute biliary pancreatitis [38] recommend ERCP for patients with any of the three high-risk criteria of cholangitis, radiological evidence of calculi, and total bilirubin >4 mg/dl combined with bile duct dilation. A meta-analysis [22] involving 519 patients with pancreatitis and biliary obstruction found that routine use of ERCP reduced local complications.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of PTCD and ERCP in patients with obstructive severe acute biliary pancreatitis

Sun

Zhang

et al. 2022

Preprint

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ObjectiveThis study compared the therapeutic effects of different timing for PTCD and ERCP in obstructive severe acute biliary pancreatitis.MethodsWe evaluated the clinical data for 62 patients with obstructive severe acute biliary pancreatitis in Beijing Tiantan Hospital. The study was performed from July, 2013 to July, 2019. According to the treatment, patients were divided into three groups: conservative group (n=16), PTCD group (n=22) and ERCP group (n=24), and the PTCD and ERCP groups were divided into early (24-72 h) and delayed (>72 h) groups. Laboratory indices, recovery time of liver function, remission time of abdominal pain, hospitalization length, curability and complications were compared among groups.ResultsThe average hospitalization length, time for abdominal pain relief and laboratory indices recovery were shorter (p <0.05) in early PTCD and ERCP groups than in the conservative group. Further, the average days of hospitalization in the ERCP group was shorter (p <0.05) than in the PTCD group. The complications were low in ERCP (33.33%) and PTCD (27.27%) groups, compared to the conservative group (62.50%).ConclusionsFor patients who cannot determine the severity of biliary pancreatitis in the first place and exclude patients who have performed ERCP within 24 hours, ERCP is recommended for relieving obstruction of obstructive severe acute biliary pancreatitis within 24-72 hours, however, PTCD may be considered in patients failed to be cured by ERCP.

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“…(3) All patients were first diagnosed in our hospital. Exclusion criteria are as follows: (1) patients younger than 18 years and older than 85 years; (2) patients diagnosed with pancreatic cancer or chronic pancreatitis; (3) patients with AP during pregnancy; (4) patients with recurrent AP; (5) patients with severe liver, kidney, respiratory system, cardiovascular disease, or malignant tumors; (6) patients with local or systemic infection before the onset; and (7) patients with incomplete important data or missing target variables (Fig. 1).…”

Section: Patientsmentioning

confidence: 99%

Development and Evaluation of a Nomogram to Predict the Eventual Severity of the First Episode of Acute Pancreatitis

Zhong¹,

Luo

et al. 2022

Pancreas

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ObjectiveThe aim of this research was to establish a nomogram for early prediction of the severity of acute pancreatitis (AP).MethodsA total of 1860 AP patients from 2013 to 2020 were included in this study. According to the 2012 revised Atlanta classification, patients were divided into nonsevere AP group and severe AP (SAP) group. The baseline characteristics and first laboratory indicators after admission between the 2 groups were analyzed using univariate and multivariate logistic regression analysis in training set. R language was used for establishing a predictive nomogram and further verified in validation set.ResultsUnivariate and multivariate logistic regression analysis in the training set showed red blood cell distribution width, d-dimer, apolipoprotein A1, and albumin were independent factors for SAP. A predictive nomogram was accordingly established based on the 4 indicators. Validation on this predictive nomogram showed high internal validation concordance index of 0.940 (95% confidence interval, 0.922–0.958) and high external validation concordance index of 0.943 (95% confidence interval, 0.920–0.966). The calibration curve, receiver operating characteristic curve, and decision curve analysis all showed that the nomogram had good predictive ability.ConclusionsThis nomogram may be an effective clinical tool for predicting the first episode of SAP.

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Management of biliary acute pancreatitis

Cited by 28 publications

References 57 publications

Evaluation and management of acute pancreatitis

Evaluation and management of acute pancreatitis

Therapeutic effects of PTCD and ERCP in patients with obstructive severe acute biliary pancreatitis

Development and Evaluation of a Nomogram to Predict the Eventual Severity of the First Episode of Acute Pancreatitis

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