The International Association of Pancreatology, alongside the American Pancreatic
Association, the European Pancreatic Club, the Indian Pancreas Club, and the Japan
Pancreas Society, decided to update its earlier guidelines for the management of acute
pancreatitis (AP) given the remarkable advances in our understanding of AP and its
management over the last decade.These organizations put together a group of international
experts to address important issues related to the management of AP. Guideline Development
Groups comprising international domain experts framed clinically relevant questions
and conducted thorough literature searches and systematic reviews to address the questions.
Questions were framed in the PICO (Participant, Intervention, Comparator, and Outcome)
format where appropriate. The evidence from the literature was synthesized to develop
evidence-based recommendations for each question. The quality of evidence and the
strength of the recommendations were graded according to the Grading of Recommendations
Assessment, Development and Evaluation (GRADE). For some questions, we have provided
Good Practice Statements if enough direct evidence was unavailable.The guidelines
pertain to 18 domains comprising 96 questions. The recommendations cover almost all
aspects of managing AP, including pain control, fluid therapy, patient stabilization,
nutritional support, conservative and interventional treatment for infected necrotizing
pancreatitis, management of complications, discharge criteria, guidance on follow-up,
and strategies for prevention of recurrence. Specific types of AP, such as those associated
with pregnancy, trauma, and metabolic factors have been given special attention.The
recommendations presented here should serve as an evidence-based resource for practicing
physicians and caregivers to treat patients with AP more effectively. In addition,
the guidelines identify areas for future research, mainly targeted therapies for controlling
systemic inflammation and mitigating organ dysfunction.
