HealthResJ, health, medicine, nursing, research https://ejournals.epublishing.ekt.gr/index.php/HealthResJ/sitemap

Management of acute pancreatitis in the Emergency Department

PDF
Published: Oct 10, 2022
DOI: https://doi.org/10.12681/healthresj.31560
Keywords:
Acute pancreatitis management emergency department
Ioannis Tsiampas
Surgical Resident, 4th General Surgery Clinic, General Hospital of Athens “Evaggelismos”, Greece
Abstract

Background: Heterogeneity in clinical manifestations and outcome of pancreatitis constitutes an obstacle for the creation of a common treatment algorithm by the scientific community.


Aim: The aim of the present study was to systematically review the management of cases of acute pancreatitis in Emergency Department (ED) and her correlation with outcome.


Methods: Search the database Pubmed and were included observational studies and randomized trials in adults in English.


Results: The search yielded 13 studies. Of these, 3 concerned the diagnostic approach of the disease in ED and concluded that lipase is the most reliable test in diagnosis, while computed tomography of the abdomen is not recommended as a routine examination. 5 out of 13 studies analyzed the usefulness of disease severity classification systems, with the BISAP and HASP score appearing as reliable as the APACHE II and RANSON score, but having an advantage in rapid patient evaluation. The last 5, studied the need for immediate therapeutic / invasive method, with the time of surgery from the arrival at the ED being decisive as it affects the outcome of the disease. It is generally seen that the early invasive method is gaining ground in the treatment of the disease.


Conclusion: The main goal is to predict the most severe forms of the disease in order to receive the right (invasive or not) treatment to improve survival and quality of life.

Article Details
  • Section
  • Systemic Review

Copyright notice:

The journal "Health and Research Journal" reserves the rights for copyright of the content of the website and also the copyright of the articles published.

By virtue of their appearance in this journal, the articles are free to be used for non-commercial purposes. However, the articles cannot and must not be used in anyway, published elsewhere or modified without any reference to the author and the first publication of the article.

Downloads
Download data is not yet available.
References
Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology 2013;13(4 Suppl 2):e1–e15.
Waller A, Long B, Koyfman A, Gottlieb M. Acute Pancreati-tis: Updates for Emergency Clinicians. The Journal of Emergency Medicine. 2018; doi:10.1016 /j.jemermed.2018.08.009
Gapp J, Chandra S. Acute Pancreatitis. [StatPearls]. Treas-ure Island (FL): StatPearls Publishing; 2020.
Dudeja V, Christein JD, Jensen EH, Vickers SM.Textbook of Surgery.20th Edition. Sabiston; 2017
Beger HG, Rau BM.Severe acute pancreatitis: Clinical course and management. World J Gastroenterol 2007;13:5043-5051
Mohy-ud-din N, Morrissey S. Pancreatitis. [StatPearls]. Treasure Island (FL): StatPearls Publishing; 2020.
Kuo DC, Rider AC, Estrada P, Kim D, Pillow MT.Acute Pan-creatitis: What’s the Score? The Journal of Emergency Medicine 2015;48(6), 762–770.
Buxbaum J, Quezada M, Chong B, et al.The Pancreatitis Activity Scoring System predicts clinical outcomes in acute pancreatitis: findings from a prospective cohort study.Am J Gastroenterol 2018;113:755-64.
Shah A, Mourad M, Bramhall S.Acute pancreatitis:current perspectives on diagnosis and management.Journal of In-flammation Research 2018;Vol. 11, 77–85.
Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation.Radiology 2002;223:603–13.
Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW, Catena F.WSES guidelines for the management of severe acute pancreatitis. World Journal of Emergency Surgery 2019; 14(1). doi:10.1186/s13017-019-0247-0
Ismail OZ, Bhayana V. Lipase or amylase for the diagnosis of acute pancreatitis? Clinical Biochemistry 2017;50(18), 1275–1280.
Kothari S, Kalinowski M, Kobeszko M, Almouradi T. Com-puted tomography scan imaging in diagnosing acute un-complicated pancreatitis: Usefulness vs cost. World J Gas-troenterol. 2019;25(9):1080-1087.
Shinagare AB, Ip IK, Raja AS, Sahni VA, Banks P, Khorasani R. Use of CT and MRI in emergency department patients with acute pancreatitis. Abdominal Imaging 2014;40(2), 272–277.
Huang J, Qu HP, Zheng YF, Song XW, Li L, Xu ZW, Mao EQ, Chen EZ. The revised Atlanta criteria 2012 altered the classification, severity assessment and management of acute pancreatitis. Hepatobiliary Pancreat Dis Int 2016;15(3):310-5.
Arif A, Jaleel F, Rashid K. Accuracy of BISAP score in pre-diction of severe acute pancreatitis. Pak J Med Sci 2019;35(4):1008-1012.
Hagjer S, Kumar N. Evaluation of the BISAP scoring sys-tem in prognostication of acute pancreatitis - A prospec-tive observational study. Int J Surg 2018;54(Pt A):76-81.
Al-Qahtani HH, Alam MKh, Waheed M. Comparison of Harmless Acute Pancreatitis Score with Ranson's Score in Predicting the Severity of Acute Pancreatitis. J Coll Physi-cians Surg Pak 2017;27(2):75-79. PMID: 28292382
Harshit Kumar A, Singh Griwan M. A comparison of APACHE II, BISAP, Ranson's score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification. Gastroenterol Rep (Oxf). 2018;6(2):127-131.
Gülen B, Dur A, Serinken M, Karcıoğlu Ö, Sönmez E. Pain treatment in patients with acute pancreatitis: A random-ized controlled trial. Turk J Gastroenterol 2016;27(2):192-6.
Schepers NJ, Bakker OJ, Besselink MG, Bollen TL, Dijkgraaf MG, van Eijck CH, Fockens P, van Geenen EJ, van Grinsven J, Hallensleben ND, Hansen BE, van Santvoort HC, Timmer R, Anten MP, Bolwerk CJ, van Delft F, van Dullemen HM, Erkelens GW, van Hooft JE, Laheij R, van der Hulst RW, Jansen JM, Kubben FJ, Kuiken SD, Perk LE, de Ridder RJ, Rijk MC, Römkens TE, Schoon EJ, Schwartz MP, Spanier BW, Tan AC, Thijs WJ, Venneman NG, Vleggaar FP, van de Vrie W, Witteman BJ, Gooszen HG, Bruno MJ; Dutch Pan-creatitis Study Group. Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial. Trials 2016;17:5.
Karjula H, Nordblad Schmidt P, Mäkelä J, Liisanantti JH, Ohtonen P, Saarela A. Prophylactic pancreatic duct stent-ing in severe acute necrotizing pancreatitis: a prospective randomized study. Endoscopy. 2019;51(11):1027-1034.
van Brunschot S, van Grinsven J, van Santvoort HC, Bakker OJ, Besselink MG, Boermeester MA, Bollen TL, Bosscha K, Bouwense SA, Bruno MJ, Cappendijk VC, Consten EC, Dejong CH, van Eijck CH, Erkelens WG, van Goor H, van Grevenstein WMU, Haveman JW, Hofker SH, Jansen JM, Laméris JS, van Lienden KP, Meijssen MA, Mulder CJ, Nieuwenhuijs VB, Poley JW, Quispel R, de Ridder RJ, Römkens TE, Scheepers JJ, Schepers NJ, Schwartz MP, Seerden T, Spanier BWM, Straathof JWA, Strijker M, Tim-mer R, Venneman NG, Vleggaar FP, Voermans RP, Wit-teman BJ, Gooszen HG, Dijkgraaf MG, Fockens P; Dutch Pancreatitis Study Group. Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multi-centre randomised trial. Lancet 2018 ;391(10115):51-58.
Noel R, Arnelo U, Lundell L, Hammarqvist F, Jumaa H, Enochsson L, Sandblom G. Index versus delayed cholecys-tectomy in mild gallstone pancreatitis: results of a ran-domized controlled trial. HPB (Oxford). 2018;20(10):932-938.
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis 2012: revision of the Atlanta classifica-tion and definitions by international consensus. Pancreas 2013;62(1):102–111
Yang YX, Li L. Evaluating the Ability of the Bedside Index for Severity of Acute Pancreatitis Score to Predict Severe Acute Pancreatitis: A Meta-Analysis. Med Princ Pract 2016;25(2):137-42.
Du XJ, Hu WM, Xia Q, Huang ZW, Chen GY, Jin XD, et al. Hydroxyethyl starchresuscitation reduces the risk of intra-abdominal hypertension in severe acutepancreatitis. Pan-creas 2011;40:1220e5
Wu BU, Hwang JQ, Gardner TH, Repas K, Delee R, Yu S, Smith B, Banks PA, Conwell DL. Lactated Ringer's solution reduces systemic inflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepa-tol. 2011;9(8):710-717.
Iqbal U, Anwar H, Scribani M. Ringer's lactate versus nor-mal saline in acute pancreatitis: A systematic review and meta-analysis.J Dig Dis 2018;19(6):335-341.
Wilson CT, de Moya MA Review Cholecystectomy for acute gallstone pancreatitis: early vs delayed approach. 2010.
Gurusamy KS, Nagendran M, Davidson BR. Early versus delayed laparoscopic cholecystectomy for acute gallstone pancreatitis. Cochrane Database Syst Rev 2013 Sep 2;(9):CD010326.
Coutinho LMA, Bernardo WM, Rocha RS, Marinho FR, Delgado A, Moura ETH, Matuguma SE, Chaves D, Franzini TAP, Sakai P, de Moura EGH. Early Endoscopic Retrograde Cholangiopancreatography Versus Conservative Treat-ment in Patients With Acute Biliary Pancreatitis: Systemat-ic Review and Meta-analysis of Randomized Controlled Trials. Pancreas 2018;47(4):444-453.
Karakayali FY. Surgical and interventional management of complications caused by acute pancreatitis. World J Gas-troenterol 2014;20(37):13412-23.
Wroński M, Cebulski W, Witkowski B, Jankowski M, Kluciński A, Krasnodębski IW, Słodkowski M.J Surg Res 2017; 210:22-31.