Current concepts in the management of acute pancreatitis
Guidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2016;volume=5;issue=4;spage=752;epage=758;aulast=Srinivasan |
| _version_ | 1819292179729743872 |
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| author | Gautham Srinivasan L Venkatakrishnan Swaminathan Sambandam Gursharan Singh Maninder Kaur Krishnaveni Janarthan B Joseph John |
| author_facet | Gautham Srinivasan L Venkatakrishnan Swaminathan Sambandam Gursharan Singh Maninder Kaur Krishnaveni Janarthan B Joseph John |
| author_sort | Gautham Srinivasan |
| collection | DOAJ |
| description | Guidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early. The vast majority of patients with AP have mild disease and can be managed at smaller centers. Early aggressive fluid resuscitation with controlled fluid expansion, early enteral nutrition, and culture-directed antibiotics improve outcomes in AP. Infected pancreatic necrosis should be managed in a tertiary care hospital within a multidisciplinary setup. The “step up” approach involving antibiotics, percutaneous drainage, and minimally invasive necrosectomy instituted sequentially based on clinical response has improved the outcomes in this subgroup of patients. |
| first_indexed | 2024-12-24T03:50:25Z |
| format | Article |
| id | doaj.art-244ab263fce3433bac6aa973a1a132ec |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-12-24T03:50:25Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-244ab263fce3433bac6aa973a1a132ec2022-12-21T17:16:36ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632016-01-015475275810.4103/2249-4863.201144Current concepts in the management of acute pancreatitisGautham SrinivasanL VenkatakrishnanSwaminathan SambandamGursharan SinghManinder KaurKrishnaveni JanarthanB Joseph JohnGuidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early. The vast majority of patients with AP have mild disease and can be managed at smaller centers. Early aggressive fluid resuscitation with controlled fluid expansion, early enteral nutrition, and culture-directed antibiotics improve outcomes in AP. Infected pancreatic necrosis should be managed in a tertiary care hospital within a multidisciplinary setup. The “step up” approach involving antibiotics, percutaneous drainage, and minimally invasive necrosectomy instituted sequentially based on clinical response has improved the outcomes in this subgroup of patients.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2016;volume=5;issue=4;spage=752;epage=758;aulast=SrinivasanAcute pancreatitisconceptsmanagement |
| spellingShingle | Gautham Srinivasan L Venkatakrishnan Swaminathan Sambandam Gursharan Singh Maninder Kaur Krishnaveni Janarthan B Joseph John Current concepts in the management of acute pancreatitis Journal of Family Medicine and Primary Care Acute pancreatitis concepts management |
| title | Current concepts in the management of acute pancreatitis |
| title_full | Current concepts in the management of acute pancreatitis |
| title_fullStr | Current concepts in the management of acute pancreatitis |
| title_full_unstemmed | Current concepts in the management of acute pancreatitis |
| title_short | Current concepts in the management of acute pancreatitis |
| title_sort | current concepts in the management of acute pancreatitis |
| topic | Acute pancreatitis concepts management |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2016;volume=5;issue=4;spage=752;epage=758;aulast=Srinivasan |
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