title: The "golden hours" of management in acute pancreatitis.
abstract: In the past decade, a significant amount of active and enthusiastic research has changed the way we treat acute pancreatitis (AP) within the first 24 hours of presentation. We highlight the importance of rapid initiation of treatment to help prevent the considerable morbidity and mortality that can occur when interventions are delayed. We review recent data that validate simple and accurate tools for prognostication of AP to replace the older, more tedious methods that relied on numerous factors and required up to 48 hours to complete. Additionally, we aim to provide evidence-based guidelines and end points for fluid resuscitation. Finally, we hope to bring clarification to two previously controversial topics in AP treatment: the use of prophylactic antibiotics and early endoscopic retrograde cholangiopancreatography.
authors.affiliation: Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Fisher
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
mesh_terms: D000208:Acute Disease; D002779:Cholestasis / Q000150:complications; D019317:Evidence-Based Medicine; D005440:Fluid Therapy; D006801:Humans; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D012720:Severity of Illness Index