Acute pancreatitis.
OBJECTIVE
To review advances over the last year in the prevention, diagnosis and management of acute pancreatitis.


RESULTS
Obesity is an independent risk factor for severity in acute pancreatitis, and heavy alcohol consumption for the development of necrosis in severe acute pancreatitis. Biochemical markers have been further tested, including carbohydrate-deficient transferrin for the diagnosis of alcohol-induced acute pancreatitis, urinary trypsinogen-2 as a diagnostic marker for acute pancreatitis, and interleukin-6 and procalcitonin as markers of disease severity. A new, simple stratification system, the 'panc 3 score', has been described. There are conflicting data on the use of antibiotic prophylaxis in acute necrotizing pancreatitis, and on the chemoprevention of postendoscopic retrograde cholangiopancreatography pancreatitis. Enteral feeding is established as standard practice early in the management of acute pancreatitis of all aetiologies; probiotics and other compounds may also play a role.


CONCLUSIONS
Over the last year, there have been further innovations in the risk stratification and management of acute pancreatitis. Unresolved issues include chemoprevention of endoscopic retrograde cholangiopancreatography-induced acute pancreatitis, the indications for antibiotic prophylaxis in severe acute pancreatitis and nutritional supplementation with probiotics and synbiotics.
Skipworth
James R A
JR
Department of Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
Pereira
Stephen P
SP
D000208:Acute Disease; D015415:Biomarkers; D019587:Dietary Supplements; D006801:Humans; D009752:Nutritional Status; D009765:Obesity / Q000150:complications; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D018570:Risk Assessment
D015415:Biomarkers