Highlights & Basics
- Acute pancreatitis most commonly presents as severe mid-epigastric or left upper quadrant pain that radiates to the back. Epigastric tenderness is typical.
- Symptoms often include nausea and vomiting. A history of cholelithiasis or alcohol intake may be present.
- Signs of hypovolemia (including decreased skin turgor, dry mucous membranes, hypotension, and sweating) are common. In more severe cases, the patient may be tachycardic and/or tachypneic.
- In most patients who present with typical clinical signs, the diagnosis is confirmed by elevated serum lipase or amylase (>3 times upper limit of normal).
- Treatment includes moderately aggressive fluid resuscitation with close monitoring, analgesia, and nutritional support, with early oral feeding favored if tolerated.
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History & Exam
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Citations
Tenner S, Vege S, Sheth S, et al. American College of Gastroenterology guidelines: management of acute pancreatitis. Am J Gastroenterol. 2024 Mar 119(3):419-37.[Abstract][Full Text]
Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019 Jun 13;14:27.[Abstract][Full Text]
Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15.[Abstract][Full Text]
American College of Radiology. ACR appropriateness criteria: acute pancreatitis. 2019 [internet publication].[Full Text]
Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis. Gastroenterology. 2018 Mar;154(4):1096-101.
1. Nirula R. Chapter 9: Diseases of the pancreas. High yield surgery. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.
2. Banks PA, Bollen TL, Dervenis C, et al; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis - 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013 Jan;62(1):102-11.[Abstract][Full Text]
3. Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990 Feb;174(2):331-6.[Abstract]
4. Doherty GM, Meko JB, Olson JA, et al. Chapter 17: Pancreas. In: The Washington manual of surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999.
5. Way LW, Doherty GM. Chapter 27: Pancreas. In: Current surgical diagnosis & treatment. 11th ed. New York, NY: McGraw-Hill; 2003.
6. Raghu MG, Wig JD, Kochhar R, et al. Lung complications in acute pancreatitis. JOP. 2007 Mar 10;8(2):177-85.[Abstract]
7. Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute pancreatitis. Lancet. 2020 Sep 5;396(10252):726-34.[Abstract][Full Text]
8. Tenner S, Vege S, Sheth S, et al. American College of Gastroenterology guidelines: management of acute pancreatitis. Am J Gastroenterol. 2024 Mar 119(3):419-37.[Abstract][Full Text]
9. Kingsnorth A, O'Reilly D. Acute pancreatitis. BMJ. 2006 May 6;332(7549):1072-6.[Full Text]
10. Xiao AY, Tan ML, Wu LM, et al. Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol. 2016 Sep;1(1):45-55.[Abstract]
11. Li CL, Jiang M, Pan CQ, et al. The global, regional, and national burden of acute pancreatitis in 204 countries and territories, 1990-2019. BMC Gastroenterol. 2021 Aug 25;21(1):332.[Abstract][Full Text]
12. Munoz A, Katerndahl DA. Diagnosis and management of acute pancreatitis. Am Fam Physician. 2000 Jul 1;62(1):164-74.[Abstract][Full Text]
13. Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2021. Gastroenterology. 2022 Feb;162(2):621-44.[Abstract][Full Text]
14. Whitcomb DC. Clinical practice: acute pancreatitis. N Engl J Med. 2006 May 18;354(20):2142-50.
15. Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. JAMA. 2021 Jan 26;325(4):382-90.[Abstract]
16. Roberts SE, Morrison-Rees S, John A, et al. The incidence and aetiology of acute pancreatitis across Europe. Pancreatology. 2017 Mar - Apr;17(2):155-65.[Abstract]
17. van Brummelen SE, Venneman NG, van Erpecum KJ, et al. Acute idiopathic pancreatitis: does it really exist or is it a myth? Scand J Gastroenterol Suppl. 2003;(239):117-22.[Abstract]
18. Hines OJ, Pandol SJ. Management of severe acute pancreatitis. BMJ. 2019 Dec 2;367:l6227.[Abstract]
19. Brunicardi FC, Andersen DK, Billiar TR. Chapter 32: Pancreas. In: Schwartz's principles of surgery. 8th ed. New York, NY: McGraw-Hill; 2005.
20. Underwood TW, Frye CB. Drug-induced pancreatitis. Clin Pharm. 1993 Jun;12(6):440-8.[Abstract]
21. Gelrud A, Sheth S, Banerjee S, et al. Analysis of cystic fibrosis gener product (CFTR) function in patients with pancreas divisum and recurrent acute pancreatitis. Am J Gastroenterol. 2004 Aug;99(8):1557-62.[Abstract]
22. Maxson CJ, Greenfield SM, Turner JL. Acute pancreatitis as a common complication of 2',3'-dideoxyinosine therapy in the acquired immunodeficiency syndrome. Am J Gastroenterol. 1992 Jun;87(6):708-13.[Abstract]
23. Tenner S. Drug induced acute pancreatitis: does it exist? World J Gastroenterol. 2014 Nov 28;20(44):16529-34.[Abstract][Full Text]
24. Saini J, Marino D, Badalov N, et al. Drug-induced acute pancreatitis: an evidence-based classification (revised). Clin Transl Gastroenterol. 2023 Aug 1;14(8):e00621.[Abstract][Full Text]
25. Sah RP, Saluja A. Molecular mechanisms of pancreatic injury. Curr Opin Gastroenterol. 2011 Sep;27(5):444-51.[Abstract][Full Text]
26. Townsend C. Chapter 53: exocrine pancreas. In: Sabiston textbook of surgery board review. 17th ed. Philadelphia, PA: Saunders; 2004.
27. Carr RA, Rejowski BJ, Cote G2, et al. Systematic review of hypertriglyceridemia-induced acute pancreatitis: A more virulent etiology? Pancreatology. 2016 Jul-Aug;16(4):469-76.[Abstract]
28. Leppäniemi A, Tolonen M, Tarasconi A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019 Jun 13;14:27.[Abstract][Full Text]
29. Bálint ER, Fűr G, Kiss L, et al. Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis. Sci Rep. 2020 Oct 21;10(1):17936.[Abstract][Full Text]
30. Frick TW, Wiegand D, Bimmler D, et al. A rat model to study hypercalcemia-induced acute pancreatitis. Int J Pancreatol. 1994 Apr;15(2):91-6.[Abstract]
31. Frick TW, Spycher MA, Heitz PU, et al. Hypercalcaemia and pancreatic ultrastructure in cats. Eur J Surg. 1992 May;158(5):289-94.[Abstract]
32. Juang P, Page RL, Zolty R. Probable loop diuretic-induced pancreatitis in a sulfonamide-allergic patient. Ann Pharmacother. 2006 Jan;40(1):128-34.[Abstract]
33. Akshintala VS, Sperna Weiland CJ, Bhullar FA, et al. Non-steroidal anti-inflammatory drugs, intravenous fluids, pancreatic stents, or their combinations for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2021 Sep;6(9):733-42.[Abstract]
34. Márta K, Gede N, Szakács Z, et al. Combined use of indomethacin and hydration is the best conservative approach for post-ERCP pancreatitis prevention: a network meta-analysis. Pancreatology. 2021 Oct;21(7):1247-55.[Abstract][Full Text]
35. American Society for Gastrointestinal Endoscopy guideline on post-ERCP pancreatitis prevention strategies: summary and recommendations. Feb 2023 [internet publication].[Full Text]
36. Heyries L, Barthet M, Delvasto C, et al. Long-term results of endoscopic management of pancreas divisum with recurrent acute pancreatitis. Gastrointest Endosc. 2002 Mar;55(3):376-81.[Abstract]
37. Strand DS, Law RJ, Yang D, et al. AGA clinical practice update on the endoscopic approach to recurrent acute and chronic pancreatitis: expert review. Gastroenterology. 2022 Oct;163(4):1107-14.[Abstract]
38. Spicak J. Etiological factors of acute pancreatitis [in Czech]. Vnitr Lek. 2002 Sep;48(9):829-41.[Abstract]
39. Guda NM, Muddana V, Whitcomb DC, et al. Recurrent acute pancreatitis: international state-of-the-science conference with recommendations. Pancreas. 2018 Jul;47(6):653-66.[Abstract]
40. Vitone LJ, Greenhalf W, Howes NR, et al. Hereditary pancreatitis and secondary screening for early pancreatic cancer. Rocz Akad Med Bialymst. 2005;50:73-84.[Abstract]
41. Whitcomb DC. Genetic risk factors for pancreatic disorders. Gastroenterology. 2013 Jun;144(6):1292-302.[Abstract][Full Text]
42. Whitcomb DC. Genetic aspects of pancreatitis. Annu Rev Med. 2010;61:413-24.[Abstract]
43. Giefer MJ, Lowe ME, Werlin SL, et al. Early-onset acute recurrent and chronic pancreatitis is associated with PRSS1 or CTRC gene mutations. J Pediatr. 2017 Jul;186:95-100.[Abstract][Full Text]
44. Dumonceau JM, Kapral C, Aabakken L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2020 Feb;52(2):127-49.[Abstract][Full Text]
45. Buxbaum J, Yan A, Yeh K, et al. Aggressive hydration with lactated Ringer's solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol. 2014 Feb;12(2):303-7.e1.[Abstract][Full Text]
46. Wu D, Wan J, Xia L, et al. The efficiency of aggressive hydration with lactated ringer solution for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. J Clin Gastroenterol. 2017 Sep;51(8):e68-76.[Abstract]
47. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013 Jul-Aug;13(4 Suppl 2):e1-15.[Abstract][Full Text]
48. National Institute for Health and Care Excellence. Pancreatitis. Dec 2020 [internet publication].[Full Text]
49. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Crit Care Med. 2003 Apr;31(4):1250-6.[Abstract]
50. Bass G, Gilani SN, Walsh TN. Validating the 5Fs mnemonic for cholelithiasis: time to include family history. Postgrad Med J. 2013 Nov;89(1057):638-41.[Abstract]
51. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012 Apr;6(2):172-87.[Abstract][Full Text]
52. Zuo L, Wang CH, Yang JL, et al. The role of a workflow in diagnosing biliary causes for acute pancreatitis [in Chinese]. Zhonghua Nei Ke Za Zhi. 2012 Feb;51(2):104-7.[Abstract]
53. Rompianesi G, Hann A, Komolafe O, et al. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis. Cochrane Database Syst Rev. 2017 Apr 21;(4):CD012010.[Abstract][Full Text]
54. Choosing Wisely. American Society for Clinical Pathology: testing for amylase. Sep 2016 [internet publication].[Full Text]
55. Steinberg WM, Nauck MA, Zinman B, et al. LEADER 3--lipase and amylase activity in subjects with type 2 diabetes: baseline data from over 9000 subjects in the LEADER Trial. Pancreas. 2014 Nov;43(8):1223-31.[Abstract][Full Text]
56. Brown A, Orav J, Banks PA. Hemoconcentration is an early marker for organ failure and necrotizing pancreatitis. Pancreas. 2000 May;20(4):367-72.[Abstract]
57. Tenner S, Dubner H, Steinberg W. Predicting gallstone pancreatitis with laboratory parameters: a meta-analysis. Am J Gastroenterol. 1994 Oct;89(10):1863-6.[Abstract]
58. Khanna AK, Meher S, Prakash S, et al. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI scores, IL-6, CRP, and procalcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis. HPB Surg. 2013;2013:367581.[Abstract][Full Text]
59. Komolafe O, Pereira SP, Davidson BR, et al. Serum C-reactive protein, procalcitonin, and lactate dehydrogenase for the diagnosis of pancreatic necrosis. Cochrane Database Syst Rev. 2017 Apr 21;(4):CD012645.[Abstract][Full Text]
60. Ranson JH, Rifkind KM, Turner JW. Prognostic signs and nonoperative peritoneal lavage in acute pancreatitis. Surg Gynecol Obstet. 1976 Aug;143(2):209-19.[Abstract]
61. American College of Radiology. ACR appropriateness criteria: acute pancreatitis. 2019 [internet publication].[Full Text]
62. Frossard JL, Steer ML, Pastor CM. Acute pancreatitis. Lancet. 2008 Jan 12;371(9607):143-52.
63. Fogel EL, Sherman S. ERCP for gallstone pancreatitis. N Engl J Med. 2014 Jan 9;370(2):150-7.
64. ASGE Standards of Practice Committee; Muthusamy VR, Chandrasekhara V, Acosta RD, et al. The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections. Gastrointest Endosc. 2016 Mar;83(3):481-8.[Full Text]
65. Siriwardena AK, Jegatheeswaran S, Mason JM, et al. A procalcitonin-based algorithm to guide antibiotic use in patients with acute pancreatitis (PROCAP): a single-centre, patient-blinded, randomised controlled trial. Lancet Gastroenterol Hepatol. 2022 Oct;7(10):913-21.[Abstract][Full Text]
66. Simundic AM, Bölenius K, Cadamuro J, et al. Joint EFLM-COLABIOCLI recommendation for venous blood sampling. Clin Chem Lab Med. 2018;56(12):2015-38.[Abstract]
67. McPherson RA, Pincus MR. Henry's clinical diagnosis and management by laboratory methods. 21st ed. Philadelphia, PA: Saunders; 2006.
68. Capurso G, Ponz de Leon Pisani R, Lauri G, et al. Clinical usefulness of scoring systems to predict severe acute pancreatitis: a systematic review and meta-analysis with pre and post-test probability assessment. United European Gastroenterol J. 2023 Nov;11(9):825-36.[Abstract][Full Text]
69. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55.[Abstract]
70. de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022 Sep 15;387(11):989-1000.[Abstract]
71. Gardner TB. Fluid resuscitation in acute pancreatitis - going over the WATERFALL. N Engl J Med. 2022 Sep 15;387(11):1038-9.
72. Li XW, Wang CH, Dai JW, et al. Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis. Crit Care. 2023 Mar 22;27(1):122.[Abstract][Full Text]
73. Baillie J, ed. Advances in endoscopy: current developments in diagnostic and therapeutic endoscopy. Gastroenterol Hepatol (N Y). 2010 Jan;6(1):16-8.[Full Text]
74. Darvas K, Futo J, Okros I, et al. Principles of intensive care in severe acute pancreatitis in 2008 [in Hungarian]. Orv Hetil. 2008 Nov 23;149(47):2211-20.[Abstract]
75. Curtis CS, Kudsk KA. Nutrition support in pancreatitis. Surg Clin North Am. 2007 Dec;87(6):1403-15.[Abstract]
76. Thomson A. Nutritional support in acute pancreatitis. Curr Opin Clin Nutr Metab Care. 2008 May;11(3):261-6.[Abstract]
77. Marik PE. What is the best way to feed patients with pancreatitis? Curr Opin Crit Care. 2009 Apr;15(2):131-8.[Abstract]
78. Kumari R, Sadarat F, Luhana S, et al. Evaluating the efficacy of different volume resuscitation strategies in acute pancreatitis patients: a systematic review and meta-analysis. BMC Gastroenterol. 2024 Mar 25;24(1):119.[Abstract][Full Text]
79. Choosakul S, Harinwan K, Chirapongsathorn S, et al. Comparison of normal saline versus Lactated Ringer's solution for fluid resuscitation in patients with mild acute pancreatitis, a randomized controlled trial. Pancreatology. 2018 Jul;18(5):507-12.[Abstract]
80. Hong J, Li Q, Wang Y, et al. Comparison of fluid resuscitation with lactate ringer's versus normal saline in acute pancreatitis: an updated meta-analysis. Dig Dis Sci. 2024 Jan;69(1):262-74.[Abstract][Full Text]
81. Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018 Mar 1;378(9):829-39.[Abstract][Full Text]
82. Zampieri FG, Machado FR, Biondi RS, et al. Effect of intravenous fluid treatment with a balanced solution vs 0.9% saline solution on mortality in critically ill patients: the BaSICS randomized clinical trial. JAMA. 2021 Aug 10;326(9):1-12.[Abstract][Full Text]
83. Finfer S, Micallef S, Hammond N, et al. Balanced multielectrolyte solution versus saline in critically ill adults. N Engl J Med. 2022 Jan 18 [Epub ahead of print].[Abstract]
84. Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis. Gastroenterology. 2018 Mar;154(4):1096-101.
85. Buxbaum JL, Quezada M, Da B, et al. Early aggressive hydration hastens clinical improvement in mild acute pancreatitis. Am J Gastroenterol. 2017 May;112(5):797-803.[Abstract]
86. Fisher JM, Gardner TB. The "golden hours" of management in acute pancreatitis. Am J Gastroenterol. 2012 Aug;107(8):1146-50.[Abstract]
87. van Dijk SM, Hallensleben NDL, van Santvoort HC, et al. Acute pancreatitis: recent advances through randomised trials. Gut. 2017 Nov;66(11):2024-32.[Abstract]
88. Moretti A, Papi C, Aratari A, et al. Is early endoscopic retrograde cholangiopancreatography useful in the management of acute biliary pancreatitis? A meta-analysis of randomized controlled trials. Dig Liver Dis. 2008 May;40(5):379-85.[Abstract]
89. Basurto Ona X, Rigau Comas D, Urrútia G. Opioids for acute pancreatitis pain. Cochrane Database Syst Rev. 2013 Jul 26;(7):CD009179.[Abstract][Full Text]
90. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012 Apr;60(4):616-31.[Abstract][Full Text]
91. Ramírez-Maldonado E, López Gordo S, Pueyo EM, et al. Immediate oral refeeding in patients with mild and moderate acute pancreatitis: a multicenter, randomized controlled trial (PADI trial). Ann Surg. 2021 Aug 1;274(2):255-63.[Abstract]
92. Vaughn VM, Shuster D, Rogers MAM, et al. Early versus delayed feeding in patients with acute pancreatitis: a systematic review. Ann Intern Med. 2017 Jun 20;166(12):883-92.[Abstract]
93. Bakker OJ, van Brunschot S, van Santvoort HC, et al. Early versus on-demand nasoenteric tube feeding in acute pancreatitis. N Engl J Med. 2014 Nov 20;371(21):1983-93.[Abstract][Full Text]
94. Liang XY, Wu XA, Tian Y, et al. Effects of early versus delayed feeding in patients with acute pancreatitis: a systematic review and meta-analysis. J Clin Gastroenterol. 2024 May-Jun 01;58(5):522-30.[Abstract][Full Text]
95. Arvanitakis M, Ockenga J, Bezmarevic M, et al. ESPEN guideline on clinical nutrition in acute and chronic pancreatitis. Clin Nutr. 2020 Mar;39(3):612-31.[Abstract][Full Text]
96. Yi F, Ge L, Zhao J, et al. Meta-analysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis. Intern Med. 2012;51(6):523-30.[Abstract][Full Text]
97. Mirtallo JM, Forbes A, McClave SA, et al. International consensus guidelines for nutrition therapy in pancreatitis. JPEN J Parenter Enteral Nutr. 2012 May;36(3):284-91.[Abstract]
98. Petrov MS, Zagainov V. Influence of enteral versus parenteral nutrition on blood glucose control in acute pancreatitis: a systematic review. Clin Nutr. 2007 Oct;26(5):514-23.[Abstract]
99. Petrov MS, Kukosh MV, Emelyanov NV. A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition. Dig Surg. 2006;23(5-6):336-44; discussion 344-5.[Abstract]
100. Dutta AK, Goel A, Kirubakaran R, et al. Nasogastric versus nasojejunal tube feeding for severe acute pancreatitis. Cochrane Database Syst Rev. 2020 Mar 26;(3):CD010582.[Abstract][Full Text]
101. Hsieh PH, Yang TC, Kang EY, et al. Impact of nutritional support routes on mortality in acute pancreatitis: a network meta-analysis of randomized controlled trials. J Intern Med. 2024 Jun;295(6):759-73.[Abstract][Full Text]
102. Poropat G, Giljaca V, Hauser G, et al. Enteral nutrition formulations for acute pancreatitis. Cochrane Database Syst Rev. 2015 Mar 23;(3):CD010605.[Abstract][Full Text]
103. Dellinger EP, Tellado JM, Soto NE, et al. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study. Ann Surg. 2007 May;245(5):674-83.[Abstract][Full Text]
104. Jiang K, Huang W, Yang XN, et al. Present and future of prophylactic antibiotics for severe acute pancreatitis. World J Gastroenterol. 2012 Jan 21;18(3):279-84.[Abstract][Full Text]
105. Rusu A, Munteanu AC, Arbănași EM, et al. Overview of side-effects of antibacterial fluoroquinolones: new drugs versus old drugs, a step forward in the safety profile? Pharmaceutics. 2023 Mar 1;15(3).[Abstract][Full Text]
106. Boxhoorn L, van Dijk SM, van Grinsven J, et al. Immediate versus postponed intervention for infected necrotizing pancreatitis. N Engl J Med. 2021 Oct 7;385(15):1372-81.[Abstract]
107. Yang Y, Zhang Y, Wen S, et al. The optimal timing and intervention to reduce mortality for necrotizing pancreatitis: a systematic review and network meta-analysis. World J Emerg Surg. 2023 Jan 27;18(1):9.[Abstract][Full Text]
108. Nakai Y, Shiomi H, Hamada T, et al. Early versus delayed interventions for necrotizing pancreatitis: a systematic review and meta-analysis. DEN Open. 2023 Apr;3(1):e171.[Abstract][Full Text]
109. Gurusamy KS, Belgaumkar AP, Haswell A, et al. Interventions for necrotising pancreatitis. Cochrane Database Syst Rev. 2016 Apr 16;(4):CD011383.[Abstract][Full Text]
110. Gluck M, Ross A, Irani S, et al. Endoscopic and percutaneous drainage of symptomatic walled-off pancreatic necrosis reduces hospital stay and radiographic resources. Clin Gastroenterol Hepatol. 2010 Dec;8(12):1083-8.[Abstract][Full Text]
111. Vitas GJ, Sarr MG. Selected management of pancreatic pseudocysts: operative versus expectant management. Surgery. 1992 Feb;111(2):123-30.[Abstract]
112. Chathadi KV, Chandrasekhara V, Acosta RD, et al; ASGE Standards of Practice Committee. The role of ERCP in benign diseases of the biliary tract. Gastrointest Endosc. 2015 Apr;81(4):795-803.[Full Text]
113. Li S, Gao L, Gong H, et al. Recurrence rates and risk factors for recurrence after first episode of acute pancreatitis: a systematic review and meta-analysis. Eur J Intern Med. 2023 Oct;116:72-81.[Abstract][Full Text]
114. Sankaran SJ, Xiao AY, Wu LM, et al. Frequency of progression from acute to chronic pancreatitis and risk factors: a meta-analysis. Gastroenterology. 2015 Nov;149(6):1490-500.[Abstract][Full Text]
115. Bouça-Machado T, Bouwense SAW, Brand M, et al. Position statement on the definition, incidence, diagnosis and outcome of acute on chronic pancreatitis. Pancreatology. 2023 Mar;23(2):143-50.[Abstract][Full Text]
116. Herrera ME, Seller G, de la Rubia C, et al. Hemofiltration in acute pancreatitis [in Spanish]. Med Intensiva. 2003;27:137-43.
117. Sainio V, Kemppainen E, Puolakkainen P, et al. Early antibiotic treatment in acute necrotising pancreatitis. Lancet. 1995 Sep 9;346(8976):663-7.[Abstract]
118. Hernandez-Aranda JC, Gallo-Chico B, Ramirez-Barba EJ. Nutritional support in severe acute pancreatitis. Controlled clinical trial [in Spanish]. Nutr Hosp. 1996 May-Jun;11(3):160-6.[Abstract]
119. Kotani J, Usami M, Nomura H, et al. Enteral nutrition prevents bacterial translocation but does not improve survival during acute pancreatitis. Arch Surg. 1999 Mar;134(3):287-92.[Abstract]
120. Ammori BJ. Role of the gut in the course of severe acute pancreatitis. Pancreas. 2003 Mar;26(2):122-9.[Abstract]
121. Hart PA, Bradley D, Conwell DL, et al. Diabetes following acute pancreatitis. Lancet Gastroenterol Hepatol. 2021 Aug;6(8):668-75.[Abstract]
122. Whitcomb DC, Buchner AM, Forsmark CE. AGA Clinical practice update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency: expert review. Gastroenterology. 2023 Nov;165(5):1292-301.[Abstract][Full Text]
123. Zahariev OJ, Bunduc S, Kovács A, et al. Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis. Front Med (Lausanne). 2023;10:1257222.[Abstract][Full Text]
124. Borbély RZ, Szalai EÁ, Philip BM, et al. The risk of developing splanchnic vein thrombosis in acute pancreatitis increases 3 days after symptom onset: a systematic review and meta-analysis. United European Gastroenterol J. 2024 Feb 24.[Abstract][Full Text]
125. Bråthen G, Ben-Menachem E, Brodtkorb E, et al. Chapter 29: alcohol-related seizures. EFNS guidelines of alcohol-related seizures. In: Gilhus NE, Barnes MP, Brainin M, eds. European handbook of neurological management. 2nd ed, v1. Oxford, UK: Blackwell Publishing; 2011:429-36.
126. Preiss D, Tikkanen MJ, Welsh P, et al. Lipid-modifying therapies and risk of pancreatitis: a meta-analysis. JAMA. 2012 Aug 22;308(8):804-11.[Abstract][Full Text]
127. Andriulli A, Leandro G, Niro G, et al. Pharmacologic treatment can prevent pancreatic injury after ERCP: a meta-analysis. Gastrointest Endosc. 2000 Jan;51(1):1-7.[Abstract]
128. Venneman NG, van Erpecum KJ. Gallstone disease: primary and secondary prevention. Best Pract Res Clin Gastroenterol. 2006;20(6):1063-73.[Abstract]
