Different Approaches In Diagnosis, Follow-Up And Treatment Of Acute Biliary Pancreatitis - Results Of Attitude Survey

Abstract

BACKGROUND:Acute biliary pancreatitis is one of the most frequently encountered diseases among general surgeons in emergency surgical diseases. Differences in diagnosis and treatment management of these patients, varying from physician to physician, are common in clinical practice. We aimed to present these differences and discuss the results in the light of current guidelines in the literature. METHODS:In this study, 21 questions were prepared regarding the physicians' approach in the diagnosis, follow-up and treatment of acute biliary pancreatitis (Appendix).The questionnaires were completed by face to face interviews with 94 general surgery specialists at the 20th National Surgery Congress. RESULTS:In this study, 38 (40%) of the physicians who answered the questionnaire were working in the Training and Research Hospital, 27 (29%) in the State Hospital, 19 (20%) in the University Hospital and nine in private health care was working in the establishment. 85% of the physicians were general surgery specialists with 10 years of experience. 53% (50) of the surgeons reported that they had less than five cases of acute biliary pancreatitis each month, and 35% (34) stated that they wanted amylase value daily for follow-up. Ultrasonography and computed tomography were the most commonly used imaging modalities and 15% of the respondents indicated that each patient underwent magnetic resonance cholangiopancreatography. 45% of surgeons stated that antibiotics were started at the time of diagnosis of pancreatitis. The percentage of surgeons who did not undergo cholecystectomy early in patients with mild to moderate pancreatitis was 60%. The reason for not preferring surgery in the early period was the most frequent operation difficulty with 40% and not supporting the operation in the early period. CONCLUSION:According to the attitude survey results, there are differences between general surgery specialists in the diagnosis, follow-up and treatment of acute biliary pancreatitis.Keywords: Acute biliary pancreatitis; an attitude survey of pancreatitis; management of pancreatitis.the American College of Gastroenterology (ACG) guidelines (revised in 2013) is the highest among the American-based guidelines. [2] In addition, there are three other approved international guidelines-British Gastroenterology Association guidelines, the Japan Association of Abdominal Emergency Medicine guidelines, and the International Association of Pancreatology (AP) guidelines. [3][4][5] Some institutions also have their own guidelines. [6]