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Pancreatitis

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Implementation of an acute care surgery service facilitates modern clinical practice guidelines for gallstone pancreatitis.
Murphy PB, Paskar D, Parry NG, Racz J, Vogt KN, Symonette C, Leslie K, Mele TS.
J Am Coll Surg. 2015 Nov;221(5):975-81.

Rationale for inclusion: This paper uniquely supports the creation of an ACS team in the treatment of gallstone pancreatitis and further supports the practice of cholecystectomy during index admission for gallstone pancreatitis.

Citations - 7 (as of July 2017)

Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial.
da Costa DW, Bouwense SA, Schepers NJ, Besselink MG, van Santvoort HC, van Brunschot S, Bakker OJ, Bollen TL, Dejong CH, van Goor H, Boermeester MA, Bruno MJ, van Eijck CH, Timmer R, Weusten BL, Consten EC, Brink MA, Spanier BW, Bilgen EJ, Nieuwenhuijs VB, Hofker HS, Rosman C, Voorburg AM, Bosscha K, van Duijvendijk P, Gerritsen JJ, Heisterkamp J, de Hingh IH, Witteman BJ, Kruyt PM, Scheepers JJ, Molenaar IQ, Schaapherder AF, Manusama ER, van der Waaij LA, van Unen J, Dijkgraaf MG, van Ramshorst B, Gooszen HG, Boerma D; Dutch Pancreatitis Study Group.
Lancet. 2015 Sep 26;386(10000):1261-8.

Rationale for inclusion: This represents a multi-center RCT in patients with mild biliary pancreatitis and further supports index admission cholecystectomy in patients with mild disease (utilizing defined criteria).

Citations - 57 (as of July 2017)

Surgical management of chronic pancreatitis: current utilization in the United States.
Bliss, LA; Yang, CJ; Eskander, MF; de Geus, SW; Callery, MP; Kent, TS; Moser, AJ; Freedman, SD; Tseng, JF.
HPB (Oxford). 2015 Sep;17(9):804-10.

Rationale for inclusion: Although rare, surgical intervention in chronic pancreatitis may be useful in complex cases. In a study of more than 21 000 patients, the authors attempt to identify outcomes in patients who undergo surgery. The findings suggest that surgical management is a viable management strategy that can be associated with improved long-term outcomes. Earlier surgical intervention may also reduce the need for prolonged opioid pain management.

Citations - 6 (as of July 2017)

Role of Antibiotic Prophylaxis in Necrotizing Pancreatitis: A Meta-Analysis.
Lim CL, Lee W, Liew YX, Tang SS, Chlebicki MP, Kwa AL.
J Gastrointest Surg. 2015 Mar;19(3):480-91.

Rationale for inclusion: In a meta-analysis of 11 studies including 864 patients, the use of prophylactic antibiotics was not shown to significantly reduce the incidence of infected pancreatic necrosis but appeared to affect all-cause mortality in acute necrotizing pancreatitis.

Citations - 15 (as of July 2017)

Early oral refeeding based on hunger in moderate and severe acute pancreatitis: A prospective controlled, randomized clinical trial.
Zhao XL, Zhu SF, Xue GJ, Li J, Liu YL, Wan MH, Huang W, Xia Q, Tang WF.
Nutrition. 2015 Jan;31(1):171-5.

Rationale for inclusion: Enteral nutrition in acute pancreatitis is well established. The timing however remains unclear. This prospective randomized study helps establish timing in the disease process.

Citations -  28 (as of July 2017)

Gallstone pancreatitis without cholecystectomy.
JAMA Surg. 2013 Sep;148(9):867-72.
Hwang SS, Li BH, Haigh P.

Rationale for inclusion: This is a large cohort study over a 15 year period with excellent long-term follow-up.  It demonstrates that in patients presenting with acute gallstone pancreatitis who undergo ERCP with or without sphincterotomy but did NOT receive a subsequent cholecystectomy, the overall risk for recurrence at 1, 2, and 5 years were roughly 5%, 7.5%, and 10%.  The rates are roughly double for those patients who did not receive ERCP during the index hospitalization.  This study provides strong supporting evidence for ERCP and cholecystectomy to prevent recurrence of biliary pancreatitis.

Citations - 39 (as of July 2017)

American College of Gastroenterology guideline: management of acute pancreatitis.
Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology.
Am J Gastroenterol. 2013 Sep;108(9):1400-15; 1416.

Rationale for inclusion: Utilizing GRADE methodology, this paper makes recommendations for the diagnosis and management of pancreatitis that may not be covered in the other recommended papers.

Citations - 743 (as of July 2017)

Clear liquid diet vs soft diet as the initial meal in patients with mild acute pancreatitis: a randomized interventional trial.
Rajkumar N, Karthikeyan VS, Ali SM, Sistla SC, Kate V.
Nutr Clin Pract. 2013 Jun;28(3):365-70.

Rationale for inclusion: This study is intriguing as it evaluates patients with mild acute pancreatitis and randomizes them to soft versus clear liquid diets with the finding of significantly shorter lengths of stay in those that receive the soft diet as the initial po option.

Citations - 12 (as of July 2017)

Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus.
Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group.
Gut. 2013 Jan;62(1):102-11.

Rationale for inclusion: This work represents a global consensus statement and updates the 1992 Atlanta Classification with better classifications of the disease, local complications, and systemic complications.

Citations -  1753 (as of July 2017)

A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome.
van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ahmed Ali U, Schrijver AM, Boermeester MA, van Goor H, Dejong CH, van Eijck CH, van Ramshorst B, Schaapherder AF, van der Harst E, Hofker S, Nieuwenhuijs VB, Brink MA, Kruyt PM, Manusama ER, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, Cuesta MA, Wahab PJ, Gooszen HG; Dutch Pancreatitis Study Group.
Gastroenterology. 2011 Oct;141(4):1254-63.

Rationale for inclusion: This is work from the Dutch Pancreatitis Group that illustrates that avoidance of laparotomy and delaying interventions are preferred over early and emergent interventions if at all possible.

Citations - 277 (as of July 2017)

A step-up approach or open necrosectomy for necrotizing pancreatitis.
van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; Dutch Pancreatitis Study Group.
N Engl J Med. 2010 Apr 22;362(16):1491-502.

Rationale for inclusion: This RCT evaluates the step-up approach compared to open necrosectomy and shows favorable outcomes for patients that are able to be managed with percutaneous and minimally invasive therapies.

Citations - 837 (as of July 2017)

Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis: a meta-analysis of randomized trials.
Petrov MS, van Santvoort HC, Besselink MG, van der Heijden GJ, Windsor JA, Gooszen HG.
Arch Surg. 2008 Nov;143(11):1111-7.

Rationale for inclusion: This meta-analysis of RCTs looks specifically at patients with predicted severe acute pancreatitis and clearly shows improved outcomes in those receiving enteral versus parenteral nutrition.

Citations - 207 (as of July 2017)

Meta-analysis of enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis.
Cao Y, Xu Y, Lu T, Gao F, Mo Z.
Ann Nutr Metab. 2008;53(3-4):268-75.

Rationale for inclusion: This study represents a meta-analysis of RCTs and further supports enteral nutrition over parenteral nutrition for severe acute pancreatitis.

Citations - 84 (as of July 2017)

Timing of surgical intervention in necrotizing pancreatitis.
Besselink MG, Verwer TJ, Schoenmaeckers EJ, Buskens E, Ridwan BU, Visser MR, Nieuwenhuijs VB, Gooszen HG.
Arch Surg. 2007 Dec;142(12):1194-201.

Rationale for inclusion: This work includes a retrospective review and a systematic review and is yet another work supporting a delayed approach to necrosectomy.

Citations - 250 (as of July 2017)

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