Initial Management of Acute Pancreatitis
Publication Date: March 1, 2018
Last Updated: December 16, 2022
Treatment
Summary of Recommendations of the AGA Clinical Guideline for the Initial Management of Acute Pancreatitis
In patients with acute pancreatitis, AGA suggests using goal-directed therapy for fluid management. ( Very Low , Conditional (weak) )
Comment: AGA makes no recommendation whether normal saline or ringer’s lactate is used.
612
In patients with acute pancreatitis, AGA suggests against the use of hydroxyethyl starch (HES) fluids. ( Very Low , Conditional (weak) )
612
In patients with predicted severe acute pancreatitis and necrotizing pancreatitis, AGA suggests against the use of prophylactic antibiotics. ( Low , Conditional (weak) )
612
In patients with acute biliary pancreatitis and no cholangitis, AGA suggests against the routine use of urgent ERCP. ( Low , Conditional (weak) )
612
In patients with acute pancreatitis, AGA recommends early (within 24 hours) oral feeding as tolerated rather than keeping the patient NPO. ( Moderate , Strong )
612
In patients with acute pancreatitis and inability to feed orally, AGA recommends enteral rather than parenteral nutrition. ( Moderate , Strong )
612
In patients with predicted severe or necrotizing pancreatitis requiring enteral tube feeding, AGA suggests either nasogastric or nasoenteral route. ( Low , Conditional (weak) )
612
In patients with acute biliary pancreatitis, AGA recommends cholecystectomy during the initial admission rather than following discharge. ( Moderate , Strong )
612
In patients with acute alcoholic pancreatitis, AGA recommends brief alcohol intervention during admission. ( Moderate , Strong )
612
Overview
Title
Initial Management of Acute Pancreatitis
Authoring Organization
American Gastroenterological Association