United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU).
There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach.



Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers.



The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as 'strong' and plenary voting revealed 'strong agreement' for 99 (98%) recommendations.



The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects of the medical and surgical management of chronic pancreatitis based on current available evidence. These recommendations should serve as a reference standard for existing management of the disease and as a guide for future clinical research.
Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
J Matthias
JM
Löhr
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Enrique
E
Dominguez-Munoz
Department of Gastroenterology, University of Leipzig, Leipzig, Germany.
Jonas
J
Rosendahl
Department of Surgery, Academic Medical Center Amsterdam, the Netherlands.
Marc
M
Besselink
Medizinische Klinik und Poliklinik 2, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
Julia
J
Mayerle
Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
Markus M
MM
Lerch
Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
Stephan
S
Haas
Department of Radiology, Indiana University, Indianapolis, USA.
Fatih
F
Akisik
Department of Radiology, Karolinska University Hospital and Division of Medical Imaging and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Nikolaos
N
Kartalis
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Julio
J
Iglesias-Garcia
Israelitic Hospital Hamburg, University of Hamburg, Hamburg, Germany.
Jutta
J
Keller
Department of Surgery, Academic Medical Center Amsterdam, the Netherlands.
Marja
M
Boermeester
Ludwig Maximilians University, Munich, Germany.
Jens
J
Werner
University of Geneve, Geneva, Switzerland.
Jean-Marc
JM
Dumonceau
Department of Surgery, Academic Medical Center Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Paul
P
Fockens
Department of Gastroenterology, Aarhus University, Aarhus, Denmark.
Asbjorn
A
Drewes
Klinikum Rechts der Isar, Technical University Munich, Germany.
Gürlap
G
Ceyhan
Göteborgs Universitet, Gothenburg, Sweden.
Björn
B
Lindkvist
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Joost
J
Drenth
Justus-Liebig-Universität Giessen, Giessen, Germany.
Nils
N
Ewald
Justus-Liebig-Universität Giessen, Giessen, Germany.
Philip
P
Hardt
Hospital General Universitario, Alicante, Spain.
Enrique
E
de Madaria
Technical University Munich, Munich, Germany.
Heiko
H
Witt
University Hospital Mannheim, Mannheim, Germany.
Alexander
A
Schneider
Department of Radiology, University of Verona, Verona, Italy.
Riccardo
R
Manfredi
Aalborg University, Aalborg, Denmark.
Frøkjer J
FJ
Brøndum
Department of Radiology, University Medical Centre Maribor, Maribor, Slovenia.
Sasa
S
Rudolf
St Antonius Ziekenhuis, Nieuwegein, The Netherland.
Thomas
T
Bollen
Department of Gastroenterology and Hepatology, Erasmus Medical Centre in Rotterdam, The Netherlands.
Marco
M
Bruno
Chronic pancreatitis; Development and Evaluation; Grading of Recommendations Assessment; diabetes mellitus; endoscopic therapy; evidence-based; guidelines; pancreatic exocrine insufficiency