title: Cutting-edge information for the management of acute pancreatitis.
abstract: Considering that the Japanese (JPN) guidelines for the management of acute pancreatitis were published in Takada et al. (J HepatoBiliary Pancreat Surg 13:2-6, 2006), doubts will be cast as to the reason for publishing a revised edition of the Guidelines for the management of acute pancreatitis: the JPN guidelines 2010, at this time. The rationale for this is that new criteria for the severity assessment of acute pancreatitis were made public on the basis of a summary of activities and reports of shared studies that were conducted in 2008. The new severity classification is entirely different from that adopted in the 2006 guidelines. A drastic revision was made in the new criteria. For example, about half of the cases that have been assessed previously as being 'severe' are assessed as being 'mild' in the new criteria. The JPN guidelines 2010 are published so that consistency between the criteria for severity assessment in the first edition and the new criteria will be maintained. In the new criteria, severity assessment can be made only by calculating the 9 scored prognostic factors. Severity assessment according to the contrast-enhanced computed tomography (CT) grade was made by scoring the poorly visualized pancreatic area in addition to determining the degree of extrapancreatic progress of inflammation and its extent. Changes made in accordance with the new criteria are seen in various parts of the guidelines. In the present revised edition, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is treated as an independent item. Furthermore, clinical indicators (pancreatitis bundles) are presented to improve the quality of the management of acute pancreatitis and to increase adherence to new guidelines.
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga-cho, Itabashi, Tokyo, 173-8605, Japan. takada@med.teikyo-u.ac.jp
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Miho
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Takeda
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
authors.forename: Keita
authors.initials: K
authors.lastname: Wada
authors.forename: Hodaka
authors.initials: H
authors.lastname: Amano
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
authors.forename: Shinjyu
authors.initials: S
authors.lastname: Arata
authors.forename: Morihisa
authors.initials: M
authors.lastname: Hirota
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yokoe
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.forename: Kuni
authors.initials: K
authors.lastname: Otomo
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000208:Acute Disease; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042882:Gallstones / Q000150:complications; D006801:Humans; D007564:Japan; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D014057:Tomography, X-Ray Computed