United Kingdom guidelines for the management of acute pancreatitis

doi:10.1136/gut.42.2008.s1

Cited by 160 publications

(3 citation statements)

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“…UK guidelines for the management of gallstone pancreatitis (GSP) were first published by the British Society of Gastroenterology (BSG) in 1998 7 and then amended in 2005. 8 These guidelines suggest that all patients with mild GSP should be offered definitive treatment: cholecystectomy if they are fit for surgery or endoscopic sphincterotomy (ES) if not.…”

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confidence: 99%

Definitive management of gallstone pancreatitis in England

El-Dhuwaib¹,

Deakin²,

David³

et al. 2012

Ann R Coll Surg Engl

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INTRODUCTIONThe aim of this study was to investigate whether definitive treatment of gallstone pancreatitis (GSP) by either cholecystectomy or endoscopic sphincterotomy in England conforms with British Society of Gastroenterology (BSG) guidelines and to validate these guidelines.METHODSHospital Episode Statistics data were used to identify patients admitted for the first time with GSP between April 2007 and April 2008. These patients were followed until April 2009 to identify any who underwent definitive treatment or were readmitted with a further bout of GSP as an emergency.RESULTSA total of 5,454 patients were admitted with GSP between April 2007 and April 2008, of whom 1,866 (34.2%) underwent definitive treatment according to BSG guidelines, 1,471 on the index admission. Patients who underwent a cholecystectomy during the index admission were less likely to be readmitted with a further bout of GSP (1.7%) than those who underwent endoscopic sphincterotomy alone (5.3%) or those who did not undergo any form of definitive treatment (13.2%). Of those patients who did not undergo definitive treatment before discharge, 2,239 received definitive treatment following discharge but only 395 (17.6%) of these had this within 2 weeks. Of the 505 patients who did not undergo definitive treatment on the index admission and who were readmitted as an emergency with GSP, 154 (30.5%) were admitted during the 2 weeks immediately following discharge.CONCLUSIONSFollowing an attack of mild GSP, cholecystectomy should be offered to all patients prior to discharge. If patients are not fit for surgery, an endoscopic sphincterotomy should be performed as definitive treatment.

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confidence: 99%

Definitive management of gallstone pancreatitis in England

El-Dhuwaib¹,

Deakin²,

David³

et al. 2012

Ann R Coll Surg Engl

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“…While the exact timing of cholecystectomy after a first admission for biliary AP has been subject to controversy, all scientific societies presently support early laparoscopic cholecystectomy for mild biliary AP, during the same admission if possible or within 4 weeks of discharge at most (13)(14)(15)(16). In this regard a Dutch pancreas team carried out a multicenter study in 266 patients with mild biliary AP.…”

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confidence: 99%

“…Some authors even suggested that cholecystectomy be performed within 24 hours of admission for predictably mild biliary AP in patients younger than 75 years with a low surgical risk (ASA < III), which would translate into reduced hospital stay and reduced need for endoscopic retrograde cholangio-pancreatography (ERCP) subsequently (18). Furthermore, the management of severe biliary AP, which is luckily less common, is more complex and cholecystectomy must be delayed until local complications are solved (13)(14)(15)(16). Similarly, in patients not fit for cholecystectomy whether because of older age, morbidity, or surgery rejection, endoscopic sphincterotomy represents a good alternative to prevent further attacks of biliary AP (19,20).…”

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confidence: 99%