Critical Care Management of Severe Acute Pancreatitis

  • Ronald TesorieroEmail author
  • Jose J. Diaz


Acute pancreatitis is a common gastrointestinal disease that results in a significant physical, psychosocial, and financial toll [2, 3]. It has become the leading gastroenterology discharge diagnosis in the United States and its incidence appears to be increasing [2, 4, 5]. The cost of caring for these patients is greater than 2 billion dollars annually, and the cost of a single survivor of severe acute pancreatitis has been estimated at $129,000 [3, 6]. There is a spectrum of disease from the mild edematous form to severe acute necrotizing pancreatitis with associated multiple organ system dysfunction. The most common form of the disease is mild with a 3–4-day self-limited course and a low mortality and occurs in nearly 80 % of patients [7, 8]. Unfortunately, 20 % of patients will develop severe acute pancreatitis with a fulminant clinical course. Those with the severe form of the disease often require prolonged intensive care unit (ICU) and hospital lengths of stay, invasive support and procedures for organ failure, and management of pancreatic necrosis and mortality rates that approach 30 % [8–11].


Systemic inflammatory response syndrome Choledocholithiasis Ranson’s criteria Atlanta classification Intra-abdominal hypertension Endoscopic retrograde cholangiopancreatography Hypertriglyceridemia 


  1. 1.
    Moynihan B. Acute pancreatitis. Ann Surg. 1925;81(1):132–42.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Peery AF, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87. e1–3.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Fagenholz PJ, et al. Direct medical costs of acute pancreatitis hospitalizations in the United States. Pancreas. 2007;35(4):302–7.PubMedGoogle Scholar
  4. 4.
    Papachristou GI, et al. Risk and markers of severe acute pancreatitis. Gastroenterol Clin North Am. 2007;36(2):277–96. viii.PubMedGoogle Scholar
  5. 5.
    Fagenholz PJ, et al. Increasing United States hospital admissions for acute pancreatitis, 1988–2003. Ann Epidemiol. 2007;17(7):491–7.PubMedGoogle Scholar
  6. 6.
    Soran A, et al. Outcome and quality of life of patients with acute pancreatitis requiring intensive care. J Surg Res. 2000;91(1):89–94.PubMedGoogle Scholar
  7. 7.
    Uhl W, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2(6):565–73.PubMedGoogle Scholar
  8. 8.
    Beger HG, Rau BM. Severe acute pancreatitis: clinical course and management. World J Gastroenterol. 2007;13(38):5043–51.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Werner J, et al. Management of acute pancreatitis: from surgery to interventional intensive care. Gut. 2005;54(3):426–36.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Gloor B, et al. Late mortality in patients with severe acute pancreatitis. Br J Surg. 2001;88(7):975–9.Google Scholar
  11. 11.
    Warshaw AL. Improving the treatment of necrotizing pancreatitis – a step up. N Engl J Med. 2010;362(16):1535–7.Google Scholar
  12. 12.
    Bradley 3rd EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993;128(5):586–90.Google Scholar
  13. 13.
    Banks PA, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.Google Scholar
  14. 14.
    McKay CJ, Imrie CW. The continuing challenge of early mortality in acute pancreatitis. Br J Surg. 2004;91(10):1243–4.Google Scholar
  15. 15.
    Renner IG, et al. Death due to acute pancreatitis. A retrospective analysis of 405 autopsy cases. Dig Dis Sci. 1985;30(10):1005–18.Google Scholar
  16. 16.
    Widdison AL, Karanjia ND. Pancreatic infection complicating acute pancreatitis. Br J Surg. 1993;80(2):148–54.Google Scholar
  17. 17.
    Blum T, et al. Fatal outcome in acute pancreatitis: its occurrence and early prediction. Pancreatology. 2001;1(3):237–41.Google Scholar
  18. 18.
    Tenner S, et al. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400–15. 1416.Google Scholar
  19. 19.
    Buter A, et al. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis. Br J Surg. 2002;89(3):298–302.Google Scholar
  20. 20.
    Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53(9):1340–4.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33(4):323–30.Google Scholar
  22. 22.
    Wilson C, Imrie CW. Changing patterns of incidence and mortality from acute pancreatitis in Scotland, 1961–1985. Br J Surg. 1990;77(7):731–4.Google Scholar
  23. 23.
    Russo MW, et al. Digestive and liver diseases statistics, 2004. Gastroenterology. 2004;126(5):1448–53.Google Scholar
  24. 24.
    McNabb-Baltar J, et al. A population-based assessment of the burden of acute pancreatitis in the United States. Pancreas. 2014;43(5):687–91.Google Scholar
  25. 25.
    Thomson SR, et al. Epidemiology and outcome of acute pancreatitis. Br J Surg. 1987;74(5):398–401.Google Scholar
  26. 26.
    Cavallini G, et al. Epidemiology of acute pancreatitis. In: Beger HG, Buchler MW, editors. Acute pancreatitis: research and clinical management. Berlin: Springer; 1987.Google Scholar
  27. 27.
    Guercioni G, Siquini W, Senati E. Epidemiology, classification, etiopathogenesis, and diagnosis of acute pancreatitis. In: Siquini W, editor. Surgical treatment of pancreatic diseases. Italia: Springer Verlag; 2009. p. 31–61.Google Scholar
  28. 28.
    Ammann RW, Muellhaupt B. Progression of alcoholic acute to chronic pancreatitis. Gut. 1994;35(4):552–6.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Gullo L, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223–7.Google Scholar
  30. 30.
    Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep. 2009;11(2):97–103.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Lee JK, Enns R. Review of idiopathic pancreatitis. World J Gastroenterol. 2007;13(47):6296–313.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Saraswat VA, et al. Biliary microlithiasis in patients with idiopathic acute pancreatitis and unexplained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004;19(10):1206–11.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Testoni PA, et al. Idiopathic recurrent pancreatitis: long-term results after ERCP, endoscopic sphincterotomy, or ursodeoxycholic acid treatment. Am J Gastroenterol. 2000;95(7):1702–7.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Fortson MR, Freedman SN, Webster 3rd PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134–9.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Valdivielso P, Ramirez-Bueno A, Ewald N. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Intern Med. 2014;25(8):689–94.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Ivanova R, et al. Triglyceride levels and apolipoprotein E polymorphism in patients with acute pancreatitis. Hepatobiliary Pancreat Dis Int. 2012;11(1):96–101.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Nagayama D, Shirai K. Hypertriglyceridemia-induced pancreatitis. Nihon Rinsho. 2013;71(9):1602–5.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Chang CC, et al. Acute pancreatitis in pregnancy. Zhonghua Yi Xue Za Zhi (Taipei). 1998;61(2):85–92.Google Scholar
  39. 39.
    Hanck C, Whitcomb DC. Alcoholic pancreatitis. Gastroenterol Clin North Am. 2004;33(4):751–65.Google Scholar
  40. 40.
    Dominguez-Munoz JE, et al. Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease. Int J Pancreatol. 1991;10(3–4):261–7.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Badalov N, et al. Drug-induced acute pancreatitis: an evidence-based review. Clin Gastroenterol Hepatol. 2007;5(6):648–61; quiz 644.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Trivedi CD, Pitchumoni CS. Drug-induced pancreatitis: an update. J Clin Gastroenterol. 2005;39(8):709–16.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas. 1996;13(4):356–71.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Debi U, et al. Pancreatic trauma: a concise review. World J Gastroenterol. 2013;19(47):9003–11.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Woods KE, Willingham FF. Endoscopic retrograde cholangiopancreatography associated pancreatitis: A 15-year review. World J Gastrointest Endosc. 2010;2(5):165–78.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Chhabra P, et al. Grey Turner’s sign in acute necrotizing pancreatitis. Ann Gastroenterol. 2015;28(1):147.PubMedPubMedCentralGoogle Scholar
  47. 47.
    Bem J, Bradley 3rd EL. Subcutaneous manifestations of severe acute pancreatitis. Pancreas. 1998;16(4):551–5.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Al-Bahrani AZ, Ammori BJ. Clinical laboratory assessment of acute pancreatitis. Clin Chim Acta. 2005;362(1–2):26–48.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol. 2002;34(4):459–62.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Yadav D, Agarwal N, Pitchumoni CS. A critical evaluation of laboratory tests in acute pancreatitis. Am J Gastroenterol. 2002;97(6):1309–18.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Clavien PA, et al. Acute pancreatitis and normoamylasemia. Not an uncommon combination. Ann Surg. 1989;210(5):614–20.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Winslet M, et al. Relation of diagnostic serum amylase levels to aetiology and severity of acute pancreatitis. Gut. 1992;33(7):982–6.PubMedPubMedCentralGoogle Scholar
  53. 53.
    Matull WR, Pereira SP, O’Donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol. 2006;59(4):340–4.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology. 2002;223(3):603–13.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Toosie K, et al. Early computed tomography is rarely necessary in gallstone pancreatitis. Am Surg. 1997;63(10):904–7.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Arvanitakis M, et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis. Gastroenterology. 2004;126(3):715–23.PubMedPubMedCentralGoogle Scholar
  57. 57.
    Zaheer A, et al. The revised Atlanta classification for acute pancreatitis: updates in imaging terminology and guidelines. Abdom Imaging. 2013;38(1):125–36.PubMedPubMedCentralGoogle Scholar
  58. 58.
    Bollen TL, et al. Comparative evaluation of the modified CT severity index and CT severity index in assessing severity of acute pancreatitis. AJR Am J Roentgenol. 2011;197(2):386–92.PubMedPubMedCentralGoogle Scholar
  59. 59.
    Bollen TL, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis. Am J Gastroenterol. 2012;107(4):612–9.PubMedPubMedCentralGoogle Scholar
  60. 60.
    Stimac D, et al. The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis. Am J Gastroenterol. 2007;102(5):997–1004.PubMedGoogle Scholar
  61. 61.
    Ranson JH, et al. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61(6):443–51.PubMedGoogle Scholar
  62. 62.
    Cho JH, et al. Comparison of scoring systems in predicting the severity of acute pancreatitis. World J Gastroenterol. 2015;21(8):2387–94.PubMedPubMedCentralGoogle Scholar
  63. 63.
    De Bernardinis M, et al. Discriminant power and information content of Ranson’s prognostic signs in acute pancreatitis: a meta-analytic study. Crit Care Med. 1999;27(10):2272–83.PubMedGoogle Scholar
  64. 64.
    Knaus WA, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818–29.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989;2(8656):201–5.PubMedGoogle Scholar
  66. 66.
    Papachristou GI, et al. Comparison of BISAP, Ranson’s, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105(2):435–41; quiz 442.PubMedGoogle Scholar
  67. 67.
    Wu BU, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57(12):1698–703.PubMedGoogle Scholar
  68. 68.
    Brown A, et al. The panc 3 score: a rapid and accurate test for predicting severity on presentation in acute pancreatitis. J Clin Gastroenterol. 2007;41(9):855–8.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Lankisch PG, et al. The harmless acute pancreatitis score: a clinical algorithm for rapid initial stratification of nonsevere disease. Clin Gastroenterol Hepatol. 2009;7(6):702–5; quiz 607.PubMedPubMedCentralGoogle Scholar
  70. 70.
    Hamada T, et al. Japanese severity score for acute pancreatitis well predicts in-hospital mortality: a nationwide survey of 17,901 cases. J Gastroenterol. 2013;48(12):1384–91.PubMedGoogle Scholar
  71. 71.
    Kuo DC et al. Acute pancreatitis: what’s the score? J Emerg Med. 2015;48(2)762–70.PubMedGoogle Scholar
  72. 72.
    Ranson JH, et al. Computed tomography and the prediction of pancreatic abscess in acute pancreatitis. Ann Surg. 1985;201(5):656–65.PubMedPubMedCentralGoogle Scholar
  73. 73.
    Balthazar EJ, et al. Acute pancreatitis: prognostic value of CT. Radiology. 1985;156(3):767–72.PubMedGoogle Scholar
  74. 74.
    Balthazar EJ, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331–6.PubMedGoogle Scholar
  75. 75.
    Leung TK, et al. Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II scoring system in predicting acute pancreatitis outcome. World J Gastroenterol. 2005;11(38):6049–52.PubMedPubMedCentralGoogle Scholar
  76. 76.
    Gurleyik G, et al. Computed tomography severity index, APACHE II score, and serum CRP concentration for predicting the severity of acute pancreatitis. JOP. 2005;6(6):562–7.PubMedGoogle Scholar
  77. 77.
    Simchuk EJ, et al. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg. 2000;179(5):352–5.PubMedGoogle Scholar
  78. 78.
    Chatzicostas C, et al. Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II and III scoring systems in predicting acute pancreatitis outcome. J Clin Gastroenterol. 2003;36(3):253–60.PubMedGoogle Scholar
  79. 79.
    Knoepfli AS, et al. Prospective study of 310 patients: can early CT predict the severity of acute pancreatitis? Abdom Imaging. 2007;32(1):111–5.PubMedGoogle Scholar
  80. 80.
    Triantopoulou C, et al. Computed tomography versus acute physiology and chronic health evaluation II score in predicting severity of acute pancreatitis: a prospective, comparative study with statistical evaluation. Pancreas. 2007;35(3):238–42.PubMedGoogle Scholar
  81. 81.
    Munoz-Bongrand N, et al. Serial computed tomography is rarely necessary in patients with acute pancreatitis: a prospective study in 102 patients. J Am Coll Surg. 2001;193(2):146–52.PubMedGoogle Scholar
  82. 82.
    Ju S, et al. Value of CT and clinical criteria in assessment of patients with acute pancreatitis. Eur J Radiol. 2006;57(1):102–7.PubMedGoogle Scholar
  83. 83.
    De Sanctis JT, et al. Prognostic indicators in acute pancreatitis: CT vs APACHE II. Clin Radiol. 1997;52(11):842–8.PubMedGoogle Scholar
  84. 84.
    Vriens PW, et al. Computed tomography severity index is an early prognostic tool for acute pancreatitis. J Am Coll Surg. 2005;201(4):497–502.PubMedGoogle Scholar
  85. 85.
    De Waele JJ, et al. Extrapancreatic inflammation on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. Pancreas. 2007;34(2):185–90.PubMedGoogle Scholar
  86. 86.
    Mortele KJ, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR Am J Roentgenol. 2004;183(5):1261–5.PubMedGoogle Scholar
  87. 87.
    Bollen TL, et al. The Atlanta classification of acute pancreatitis revisited. Br J Surg. 2008;95(1):6–21.PubMedGoogle Scholar
  88. 88.
    Singh VK, et al. Early systemic inflammatory response syndrome is associated with severe acute pancreatitis. Clin Gastroenterol Hepatol. 2009;7(11):1247–51.PubMedGoogle Scholar
  89. 89.
    Mofidi R, et al. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. Br J Surg. 2006;93(6):738–44.PubMedGoogle Scholar
  90. 90.
    Lytras D, et al. Persistent early organ failure: defining the high-risk group of patients with severe acute pancreatitis? Pancreas. 2008;36(3):249–54.PubMedGoogle Scholar
  91. 91.
    Besselink MG, et al. Timing and impact of infections in acute pancreatitis. Br J Surg. 2009;96(3):267–73.PubMedGoogle Scholar
  92. 92.
    van Santvoort HC, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362(16):1491–502.PubMedPubMedCentralGoogle Scholar
  93. 93.
    Marshall JC, et al. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23(10):1638–52.PubMedGoogle Scholar
  94. 94.
    Singh VK, et al. An assessment of the severity of interstitial pancreatitis. Clin Gastroenterol Hepatol. 2011;9(12):1098–103.PubMedGoogle Scholar
  95. 95.
    Garg PK, et al. Association of extent and infection of pancreatic necrosis with organ failure and death in acute necrotizing pancreatitis. Clin Gastroenterol Hepatol. 2005;3(2):159–66.PubMedGoogle Scholar
  96. 96.
    Isenmann R, et al. Pancreatic necrosis: an early finding in severe acute pancreatitis. Pancreas. 1993;8(3):358–61.PubMedGoogle Scholar
  97. 97.
    Petrov MS, et al. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139(3):813–20.PubMedGoogle Scholar
  98. 98.
    Vege SS, et al. Low mortality and high morbidity in severe acute pancreatitis without organ failure: a case for revising the Atlanta classification to include “moderately severe acute pancreatitis”. Am J Gastroenterol. 2009;104(3):710–5.PubMedGoogle Scholar
  99. 99.
    Petrov MS, Windsor JA. Conceptual framework for classifying the severity of acute pancreatitis. Clin Res Hepatol Gastroenterol. 2012;36(4):341–4.PubMedGoogle Scholar
  100. 100.
    Dellinger EP, et al. Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg. 2012;256(6):875–80.Google Scholar
  101. 101.
    Nawaz H, et al. Revised Atlanta and determinant-based classification: application in a prospective cohort of acute pancreatitis patients. Am J Gastroenterol. 2013;108(12):1911–7.Google Scholar
  102. 102.
    Tenner S. Initial management of acute pancreatitis: critical issues during the first 72 hours. Am J Gastroenterol. 2004;99(12):2489–94.Google Scholar
  103. 103.
    Gardner TB, et al. Fluid resuscitation in acute pancreatitis. Clin Gastroenterol Hepatol. 2008;6(10):1070–6.Google Scholar
  104. 104.
    Baillargeon JD, et al. Hemoconcentration as an early risk factor for necrotizing pancreatitis. Am J Gastroenterol. 1998;93(11):2130–4.Google Scholar
  105. 105.
    Bassi D, et al. Impairment of pancreatic microcirculation correlates with the severity of acute experimental pancreatitis. J Am Coll Surg. 1994;179(3):257–63.Google Scholar
  106. 106.
    Brown A, Orav J, Banks PA. Hemoconcentration is an early marker for organ failure and necrotizing pancreatitis. Pancreas. 2000;20(4):367–72.Google Scholar
  107. 107.
    Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101(10):2379–400.Google Scholar
  108. 108.
    Lankisch PG, et al. Hemoconcentration: an early marker of severe and/or necrotizing pancreatitis? A critical appraisal. Am J Gastroenterol. 2001;96(7):2081–5.Google Scholar
  109. 109.
    Wall I, et al. Decreased mortality in acute pancreatitis related to early aggressive hydration. Pancreas. 2011;40(4):547–50.Google Scholar
  110. 110.
    Wu BU, et al. Lactated Ringer’s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2011;9(8):710–7. e1.Google Scholar
  111. 111.
    Haydock MD, et al. National survey of fluid therapy in acute pancreatitis: current practice lacks a sound evidence base. World J Surg. 2013;37(10):2428–35.Google Scholar
  112. 112.
    Haydock MD, et al. Fluid therapy in acute pancreatitis: anybody’s guess. Ann Surg. 2013;257(2):182–8.Google Scholar
  113. 113.
    de-Madaria E, et al. Influence of fluid therapy on the prognosis of acute pancreatitis: a prospective cohort study. Am J Gastroenterol. 2011;106(10):1843–50.Google Scholar
  114. 114.
    Eckerwall G, et al. Fluid resuscitation and nutritional support during severe acute pancreatitis in the past: what have we learned and how can we do better? Clin Nutr. 2006;25(3):497–504.Google Scholar
  115. 115.
    Mao EQ, et al. Strategy of controlling fluid resuscitation for severe acute pancreatitis in acute phase. Zhonghua Wai Ke Za Zhi. 2007;45(19):1331–4.Google Scholar
  116. 116.
    Mao EQ, et al. Fluid therapy for severe acute pancreatitis in acute response stage. Chin Med J (Engl). 2009;122(2):169–73.Google Scholar
  117. 117.
    Mao EQ, et al. Rapid hemodilution is associated with increased sepsis and mortality among patients with severe acute pancreatitis. Chin Med J (Engl). 2010;123(13):1639–44.Google Scholar
  118. 118.
    Kuwabara K, et al. Early crystalloid fluid volume management in acute pancreatitis: association with mortality and organ failure. Pancreatology. 2011;11(3):351–61.Google Scholar
  119. 119.
    Ranson JH, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69–81.Google Scholar
  120. 120.
    Aggarwal A, Manrai M, Kochhar R. Fluid resuscitation in acute pancreatitis. World J Gastroenterol. 2014;20(48):18092–103.PubMedPubMedCentralGoogle Scholar
  121. 121.
    Pandol SJ, et al. Acute pancreatitis: bench to the bedside. Gastroenterology. 2007;132(3):1127–51.Google Scholar
  122. 122.
    Huber W, Malbrain ML. Goal-directed fluid resuscitation in acute pancreatitis: shedding light on the penumbra by dynamic markers of preload? Intensive Care Med. 2013;39(4):784–6.Google Scholar
  123. 123.
    Sarr MG. Early fluid “resuscitation/therapy” in acute pancreatitis: which fluid? What rate? What parameters to gauge effectiveness? Ann Surg. 2013;257(2):189–90.Google Scholar
  124. 124.
    Dellinger RP, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637.PubMedPubMedCentralGoogle Scholar
  125. 125.
    Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007;132(5):2022–44.Google Scholar
  126. 126.
    Mentula P, Leppaniemi A. Position paper: timely interventions in severe acute pancreatitis are crucial for survival. World J Emerg Surg. 2014;9(1):15.PubMedPubMedCentralGoogle Scholar
  127. 127.
    Cecconi M, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40(12):1795–815.PubMedPubMedCentralGoogle Scholar
  128. 128.
    Maravi Poma E, et al. SEMICYUC 2012. Recommendations for intensive care management of acute pancreatitis. Med Intensiva. 2013;37(3):163–79.Google Scholar
  129. 129.
    Biais M, et al. Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach. Crit Care. 2014;18(6):587.PubMedPubMedCentralGoogle Scholar
  130. 130.
    Khwannimit B, Bhurayanontachai R. Prediction of fluid responsiveness in septic shock patients: comparing stroke volume variation by FloTrac/Vigileo and automated pulse pressure variation. Eur J Anaesthesiol. 2012;29(2):64–9.Google Scholar
  131. 131.
    Marik PE, et al. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37(9):2642–7.PubMedPubMedCentralGoogle Scholar
  132. 132.
    Kent A, et al. Sonographic evaluation of intravascular volume status in the surgical intensive care unit: a prospective comparison of subclavian vein and inferior vena cava collapsibility index. J Surg Res. 2013;184(1):561–6.Google Scholar
  133. 133.
    Stawicki SP, et al. Prospective evaluation of intravascular volume status in critically ill patients: does inferior vena cava collapsibility correlate with central venous pressure? J Trauma Acute Care Surg. 2014;76(4):956–63; discussion 963–4.PubMedPubMedCentralGoogle Scholar
  134. 134.
    Murthi SB, et al. Focused rapid echocardiographic evaluation versus vascular cather-based assessment of cardiac output and function in critically ill trauma patients. J Trauma Acute Care Surg. 2012;72(5):1158–64.PubMedPubMedCentralGoogle Scholar
  135. 135.
    Murthi SB, et al. Focused comprehensive, quantitative, functionally based echocardiographic evaluation in the critical care unit is feasible and impacts care. Mil Med. 2015;180(3 Suppl):74–9.PubMedPubMedCentralGoogle Scholar
  136. 136.
    Ferrada P, et al. Transthoracic focused rapid echocardiographic examination: real-time evaluation of fluid status in critically ill trauma patients. J Trauma. 2011;70(1):56–62; discussion 62–4.PubMedPubMedCentralGoogle Scholar
  137. 137.
    Du XJ, et al. Hydroxyethyl starch resuscitation reduces the risk of intra-abdominal hypertension in severe acute pancreatitis. Pancreas. 2011;40(8):1220–5.PubMedPubMedCentralGoogle Scholar
  138. 138.
    Lobo DN. Intravenous 0.9% saline and general surgical patients: a problem, not a solution. Ann Surg. 2012;255(5):830–2.PubMedPubMedCentralGoogle Scholar
  139. 139.
    Shaw AD, et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg. 2012;255(5):821–9.Google Scholar
  140. 140.
    Yunos NM, et al. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA. 2012;308(15):1566–72.Google Scholar
  141. 141.
    Lissauer ME, et al. Association of 6% hetastarch resuscitation with adverse outcomes in critically ill trauma patients. Am J Surg. 2011;202(1):53–8.Google Scholar
  142. 142.
    Prowle JR, Pearse RM. Is it the end of the road for synthetic starches in critical illness? No place for hydroxyethyl starch solutions in treatment of patients with sepsis. BMJ. 2013;346:f1805.Google Scholar
  143. 143.
    Serpa Neto A, et al. Fluid resuscitation with hydroxyethyl starches in patients with sepsis is associated with an increased incidence of acute kidney injury and use of renal replacement therapy: a systematic review and meta-analysis of the literature. J Crit Care. 2014;29(1):185. e1–7.Google Scholar
  144. 144.
    Zarychanski R, et al. Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis. JAMA. 2013;309(7):678–88.Google Scholar
  145. 145.
    Delaney AP, et al. The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit Care Med. 2011;39(2):386–91.Google Scholar
  146. 146.
    Finfer S, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350(22):2247–56.Google Scholar
  147. 147.
    Finfer S, et al. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011;37(1):86–96.Google Scholar
  148. 148.
    Rochwerg B, et al. Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med. 2014;161(5):347–55.Google Scholar
  149. 149.
    Caironi P, et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med. 2014;370(15):1412–21.PubMedPubMedCentralGoogle Scholar
  150. 150.
    Jiang L, et al. Albumin versus other fluids for fluid resuscitation in patients with sepsis: a meta-analysis. PLoS One. 2014;9(12), e114666.PubMedPubMedCentralGoogle Scholar
  151. 151.
    Patel A, et al. Randomised trials of human albumin for adults with sepsis: systematic review and meta-analysis with trial sequential analysis of all-cause mortality. BMJ. 2014;349:g4561.PubMedPubMedCentralGoogle Scholar
  152. 152.
    Vincent JL, et al. Albumin administration in the acutely ill: what is new and where next? Crit Care. 2014;18(4):231.PubMedPubMedCentralGoogle Scholar
  153. 153.
    Horton JW, et al. Hypertonic saline-dextran resuscitation of acute canine bile-induced pancreatitis. Am J Surg. 1989;158(1):48–56.PubMedPubMedCentralGoogle Scholar
  154. 154.
    Shields CJ, et al. Attenuation of pancreatitis-induced pulmonary injury by aerosolized hypertonic saline. Surg Infect (Larchmt). 2001;2(3):215–23; discussion 223–4.Google Scholar
  155. 155.
    Shields CJ, et al. Hypertonic saline attenuates end-organ damage in an experimental model of acute pancreatitis. Br J Surg. 2000;87(10):1336–40.PubMedPubMedCentralGoogle Scholar
  156. 156.
    Wang JW, et al. Hypertonic saline in the traumatic hypovolemic shock: meta-analysis. J Surg Res. 2014;191(2):448–54.PubMedPubMedCentralGoogle Scholar
  157. 157.
    Huang PP, et al. Hypertonic sodium resuscitation is associated with renal failure and death. Ann Surg. 1995;221(5):543–54; discussion 554–7.PubMedPubMedCentralGoogle Scholar
  158. 158.
    Young JB, et al. Saline versus Plasma-Lyte A in initial resuscitation of trauma patients: a randomized trial. Ann Surg. 2014;259(2):255–62.PubMedPubMedCentralGoogle Scholar
  159. 159.
    Wilkman E, et al. Early hemodynamic variables and outcome in severe acute pancreatitis: a retrospective single-center cohort study. Pancreas. 2013;42(2):272–8.PubMedPubMedCentralGoogle Scholar
  160. 160.
    Chen H, et al. Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage. World J Gastroenterol. 2008;14(22):3541–8.PubMedPubMedCentralGoogle Scholar
  161. 161.
    Gecelter G, et al. Abdominal compartment syndrome in severe acute pancreatitis: an indication for a decompressing laparotomy? Dig Surg. 2002;19(5):402–4; discussion 404–5.PubMedPubMedCentralGoogle Scholar
  162. 162.
    Pupelis G, et al. Clinical significance of increased intraabdominal pressure in severe acute pancreatitis. Acta Chir Belg. 2002;102(2):71–4.Google Scholar
  163. 163.
    De Waele JJ, Leppaniemi AK. Intra-abdominal hypertension in acute pancreatitis. World J Surg. 2009;33(6):1128–33.Google Scholar
  164. 164.
    Kirkpatrick AW, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013;39(7):1190–206.PubMedPubMedCentralGoogle Scholar
  165. 165.
    De Waele JJ, et al. Intra-abdominal hypertension in patients with severe acute pancreatitis. Crit Care. 2005;9(4):R452–7.PubMedPubMedCentralGoogle Scholar
  166. 166.
    Jiang HL, et al. Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis. World J Gastroenterol. 2005;11(31):4815–21.PubMedPubMedCentralGoogle Scholar
  167. 167.
    Mao EQ, Tang YQ, Zhang SD. Effects of time interval for hemofiltration on the prognosis of severe acute pancreatitis. World J Gastroenterol. 2003;9(2):373–6.PubMedPubMedCentralGoogle Scholar
  168. 168.
    Oda S, et al. Management of intra-abdominal hypertension in patients with severe acute pancreatitis with continuous hemodiafiltration using a polymethyl methacrylate membrane hemofilter. Ther Apher Dial. 2005;9(4):355–61.PubMedPubMedCentralGoogle Scholar
  169. 169.
    Yan XW, et al. Effects of high-volume continuous hemofiltration on experimental pancreatitis associated lung injury in pigs. Int J Artif Organs. 2006;29(3):293–302.PubMedPubMedCentralGoogle Scholar
  170. 170.
    Oudemans-van Straaten HM, et al. Outcome of critically ill patients treated with intermittent high-volume haemofiltration: a prospective cohort analysis. Intensive Care Med. 1999;25(8):814–21.PubMedPubMedCentralGoogle Scholar
  171. 171.
    Ratanarat R, et al. Pulse high-volume haemofiltration for treatment of severe sepsis: effects on hemodynamics and survival. Crit Care. 2005;9(4):R294–302.PubMedPubMedCentralGoogle Scholar
  172. 172.
    Tapia P, et al. Effectiveness of short-term 6-hour high-volume hemofiltration during refractory severe septic shock. J Trauma Acute Care Surg. 2012;72(5):1228–37; discussion 1237–8.PubMedPubMedCentralGoogle Scholar
  173. 173.
    Gong D, et al. Improvement of immune dysfunction in patients with severe acute pancreatitis by high-volume hemofiltration: a preliminary report. Int J Artif Organs. 2010;33(1):22–9.PubMedPubMedCentralGoogle Scholar
  174. 174.
    Wang S, et al. Is continuous venovenous hemofiltration effective against severe acute pancreatitis? Artif Organs. 2013;37(7):615–22.PubMedPubMedCentralGoogle Scholar
  175. 175.
    Xie H, et al. Continuous veno venous hemofiltration in treatment of acute necrotizing pancreatitis. Chin Med J (Engl). 2003;116(4):549–53.Google Scholar
  176. 176.
    Yu C, et al. Improvement of monocyte function and immune homeostasis by high volume continuous venovenous hemofiltration in patients with severe acute pancreatitis. Int J Artif Organs. 2008;31(10):882–90.PubMedGoogle Scholar
  177. 177.
    Pupelis G, et al. Conservative approach in the management of severe acute pancreatitis: eight-year experience in a single institution. HPB (Oxford). 2008;10(5):347–55.Google Scholar
  178. 178.
    Wang H, et al. Clinical effects of continuous high volume hemofiltration on severe acute pancreatitis complicated with multiple organ dysfunction syndrome. World J Gastroenterol. 2003;9(9):2096–9.PubMedPubMedCentralGoogle Scholar
  179. 179.
    Zhang J, et al. Early gut barrier dysfunction in patients with severe acute pancreatitis: attenuated by continuous blood purification treatment. Int J Artif Organs. 2010;33(10):706–15.PubMedGoogle Scholar
  180. 180.
    Zhu Y, et al. Adjunctive continuous high-volume hemofiltration in patients with acute severe pancreatitis: a prospective nonrandomized study. Pancreas. 2011;40(1):109–13.PubMedGoogle Scholar
  181. 181.
    Pupelis G, et al. Early continuous veno-venous haemofiltration in the management of severe acute pancreatitis complicated with intra-abdominal hypertension: retrospective review of 10 years’ experience. Ann Intens Care. 2012;2 Suppl 1:S21.Google Scholar
  182. 182.
    Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med. 1994;330(17):1198–210.PubMedGoogle Scholar
  183. 183.
    Eckerwall GE, et al. Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery – a randomized clinical study. Clin Nutr. 2007;26(6):758–63.PubMedGoogle Scholar
  184. 184.
    Petrov MS. Moving beyond the ‘pancreatic rest’ in severe and critical acute pancreatitis. Crit Care. 2013;17(4):161.PubMedPubMedCentralGoogle Scholar
  185. 185.
    Petrov MS, et al. Early nasogastric tube feeding versus nil per os in mild to moderate acute pancreatitis: a randomized controlled trial. Clin Nutr. 2013;32(5):697–703.PubMedGoogle Scholar
  186. 186.
    Jacobson BC, et al. A prospective, randomized trial of clear liquids versus low-fat solid diet as the initial meal in mild acute pancreatitis. Clin Gastroenterol Hepatol. 2007;5(8):946–51; quiz 886.PubMedPubMedCentralGoogle Scholar
  187. 187.
    Moraes JM, et al. A full solid diet as the initial meal in mild acute pancreatitis is safe and result in a shorter length of hospitalization: results from a prospective, randomized, controlled, double-blind clinical trial. J Clin Gastroenterol. 2010;44(7):517–22.PubMedGoogle Scholar
  188. 188.
    Sathiaraj E, et al. Clinical trial: oral feeding with a soft diet compared with clear liquid diet as initial meal in mild acute pancreatitis. Aliment Pharmacol Ther. 2008;28(6):777–81.PubMedGoogle Scholar
  189. 189.
    Al-Omran M, et al. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev. 2010;1, CD002837.Google Scholar
  190. 190.
    Casas M, et al. Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis. Rev Esp Enferm Dig. 2007;99(5):264–9.PubMedGoogle Scholar
  191. 191.
    Li JY, et al. Enteral nutrition within 48 hours of admission improves clinical outcomes of acute pancreatitis by reducing complications: a meta-analysis. PLoS One. 2013;8(6), e64926.PubMedPubMedCentralGoogle Scholar
  192. 192.
    Louie BE, et al. 2004 MacLean-Mueller prize enteral or parenteral nutrition for severe pancreatitis: a randomized controlled trial and health technology assessment. Can J Surg. 2005;48(4):298–306.PubMedPubMedCentralGoogle Scholar
  193. 193.
    Petrov MS, Kukosh MV, Emelyanov NV. A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition. Dig Surg. 2006;23(5–6):336–44; discussion 344–5.PubMedGoogle Scholar
  194. 194.
    Petrov MS, et al. Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis: a meta-analysis of randomized trials. Arch Surg. 2008;143(11):1111–7.PubMedGoogle Scholar
  195. 195.
    Yi F, et al. Meta-analysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis. Intern Med. 2012;51(6):523–30.PubMedGoogle Scholar
  196. 196.
    Chang YS, et al. Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta-analysis. Crit Care. 2013;17(3):R118.PubMedPubMedCentralGoogle Scholar
  197. 197.
    Eatock FC, et al. A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis. Am J Gastroenterol. 2005;100(2):432–9.PubMedGoogle Scholar
  198. 198.
    Kumar A, et al. Early enteral nutrition in severe acute pancreatitis: a prospective randomized controlled trial comparing nasojejunal and nasogastric routes. J Clin Gastroenterol. 2006;40(5):431–4.PubMedGoogle Scholar
  199. 199.
    Kaushik N, et al. Enteral feeding without pancreatic stimulation. Pancreas. 2005;31(4):353–9.PubMedGoogle Scholar
  200. 200.
    Seminerio J, O’Keefe SJ. Jejunal feeding in patients with pancreatitis. Nutr Clin Pract. 2014;29(3):283–6.PubMedPubMedCentralGoogle Scholar
  201. 201.
    Besselink MG, et al. Timing of surgical intervention in necrotizing pancreatitis. Arch Surg. 2007;142(12):1194–201.PubMedPubMedCentralGoogle Scholar
  202. 202.
    Delcenserie R, Yzet T, Ducroix JP. Prophylactic antibiotics in treatment of severe acute alcoholic pancreatitis. Pancreas. 1996;13(2):198–201.PubMedPubMedCentralGoogle Scholar
  203. 203.
    Pederzoli P, et al. A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet. 1993;176(5):480–3.PubMedPubMedCentralGoogle Scholar
  204. 204.
    Sainio V, et al. Early antibiotic treatment in acute necrotising pancreatitis. Lancet. 1995;346(8976):663–7.PubMedPubMedCentralGoogle Scholar
  205. 205.
    Schwarz M, et al. Antibiotic use in necrotizing pancreatitis. Results of a controlled study. Dtsch Med Wochenschr. 1997;122(12):356–61.PubMedPubMedCentralGoogle Scholar
  206. 206.
    Garcia-Barrasa A, et al. A double-blind, placebo-controlled trial of ciprofloxacin prophylaxis in patients with acute necrotizing pancreatitis. J Gastrointest Surg. 2009;13(4):768–74.PubMedPubMedCentralGoogle Scholar
  207. 207.
    Isenmann R, et al. Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial. Gastroenterology. 2004;126(4):997–1004.PubMedPubMedCentralGoogle Scholar
  208. 208.
    Xue P, et al. Effect of antibiotic prophylaxis on acute necrotizing pancreatitis: results of a randomized controlled trial. J Gastroenterol Hepatol. 2009;24(5):736–42.PubMedPubMedCentralGoogle Scholar
  209. 209.
    Dellinger EP, et al. Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study. Ann Surg. 2007;245(5):674–83.PubMedPubMedCentralGoogle Scholar
  210. 210.
    Bai Y, et al. Prophylactic antibiotics cannot reduce infected pancreatic necrosis and mortality in acute necrotizing pancreatitis: evidence from a meta-analysis of randomized controlled trials. Am J Gastroenterol. 2008;103(1):104–10.Google Scholar
  211. 211.
    Hart PA, et al. Prophylactic antibiotics in necrotizing pancreatitis: a meta-analysis. South Med J. 2008;101(11):1126–31.Google Scholar
  212. 212.
    Jiang K, et al. Present and future of prophylactic antibiotics for severe acute pancreatitis. World J Gastroenterol. 2012;18(3):279–84.PubMedPubMedCentralGoogle Scholar
  213. 213.
    Wittau M, et al. Systematic review and meta-analysis of antibiotic prophylaxis in severe acute pancreatitis. Scand J Gastroenterol. 2011;46(3):261–70.Google Scholar
  214. 214.
    Falagas ME, Kopterides P. Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: a systematic review of the literature. J Hosp Infect. 2006;64(1):7–15.Google Scholar
  215. 215.
    Lim CL, et al. Role of antibiotic prophylaxis in necrotizing pancreatitis: a meta-analysis. J Gastrointest Surg. 2015;19(3):480–91.Google Scholar
  216. 216.
    Tacconelli E, et al. Does antibiotic exposure increase the risk of methicillin-resistant Staphylococcus aureus (MRSA) isolation? A systematic review and meta-analysis. J Antimicrob Chemother. 2008;61(1):26–38.Google Scholar
  217. 217.
    Gou S, et al. Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Crit Care. 2014;18(2):R57.PubMedPubMedCentralGoogle Scholar
  218. 218.
    Dervenis C, Smailis D, Hatzitheoklitos E. Bacterial translocation and its prevention in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2003;10(6):415–8.Google Scholar
  219. 219.
    Urben LM, et al. Bugs or drugs: are probiotics safe for use in the critically ill? Curr Gastroenterol Rep. 2014;16(7):388.Google Scholar
  220. 220.
    Besselink MG, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;371(9613):651–9.Google Scholar
  221. 221.
    Morrow LE, Gogineni V, Malesker MA. Synbiotics and probiotics in the critically ill after the PROPATRIA trial. Curr Opin Clin Nutr Metab Care. 2012;15(2):147–50.Google Scholar
  222. 222.
    Acosta JM, Ledesma CL. Gallstone migration as a cause of acute pancreatitis. N Engl J Med. 1974;290(9):484–7.Google Scholar
  223. 223.
    Fan ST, et al. Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med. 1993;328(4):228–32.Google Scholar
  224. 224.
    Neoptolemos JP, et al. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet. 1988;2(8618):979–83.Google Scholar
  225. 225.
    Arguedas MR, Dupont AW, Wilcox CM. Where do ERCP, endoscopic ultrasound, magnetic resonance cholangiopancreatography, and intraoperative cholangiography fit in the management of acute biliary pancreatitis? A decision analysis model. Am J Gastroenterol. 2001;96(10):2892–9.Google Scholar
  226. 226.
    Folsch UR, et al. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997;336(4):237–42.Google Scholar
  227. 227.
    Moretti A, et al. Is early endoscopic retrograde cholangiopancreatography useful in the management of acute biliary pancreatitis? A meta-analysis of randomized controlled trials. Dig Liver Dis. 2008;40(5):379–85.Google Scholar
  228. 228.
    Larsen M, Kozarek R. Management of pancreatic ductal leaks and fistulae. J Gastroenterol Hepatol. 2014;29(7):1360–70.Google Scholar
  229. 229.
    Fulcher AS, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: preliminary findings. J Trauma. 2000;48(6):1001–7.Google Scholar
  230. 230.
    Gillams AR, Kurzawinski T, Lees WR. Diagnosis of duct disruption and assessment of pancreatic leak with dynamic secretin-stimulated MR cholangiopancreatography. AJR Am J Roentgenol. 2006;186(2):499–506.Google Scholar
  231. 231.
    Soto JA, et al. Traumatic disruption of the pancreatic duct: diagnosis with MR pancreatography. AJR Am J Roentgenol. 2001;176(1):175–8.Google Scholar
  232. 232.
    Gurusamy KS, Nagendran M, Davidson BR. Early versus delayed laparoscopic cholecystectomy for acute gallstone pancreatitis. Cochrane Database Syst Rev. 2013;9, CD010326.Google Scholar
  233. 233.
    Hwang SS, Li BH, Haigh PI. Gallstone pancreatitis without cholecystectomy. JAMA Surg. 2013;148(9):867–72.Google Scholar
  234. 234.
    Larson SD, Nealon WH, Evers BM. Management of gallstone pancreatitis. Adv Surg. 2006;40:265–84.Google Scholar
  235. 235.
    Mador BD, Panton ON, Hameed SM. Early versus delayed cholecystectomy following endoscopic sphincterotomy for mild biliary pancreatitis. Surg Endosc. 2014;28(12):3337–42.Google Scholar
  236. 236.
    Uhl W, et al. Acute gallstone pancreatitis: timing of laparoscopic cholecystectomy in mild and severe disease. Surg Endosc. 1999;13(11):1070–6.Google Scholar
  237. 237.
    Sanjay P, et al. Endoscopic sphincterotomy and interval cholecystectomy are reasonable alternatives to index cholecystectomy in severe acute gallstone pancreatitis (GSP). Surg Endosc. 2008;22(8):1832–7.Google Scholar
  238. 238.
    Trna J, et al. Lack of significant liver enzyme elevation and gallstones and/or sludge on ultrasound on day 1 of acute pancreatitis is associated with recurrence after cholecystectomy: a population-based study. Surgery. 2012;151(2):199–205.Google Scholar
  239. 239.
    Fischer S, et al. Ursodeoxycholic acid decreases viscosity and sedimentable fractions of gallbladder bile in patients with cholesterol gallstones. Eur J Gastroenterol Hepatol. 2004;16(3):305–11.Google Scholar
  240. 240.
    Berglund L, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(9):2969–89.PubMedPubMedCentralGoogle Scholar
  241. 241.
    Scherer J, et al. Issues in hypertriglyceridemic pancreatitis: an update. J Clin Gastroenterol. 2014;48(3):195–203.PubMedPubMedCentralGoogle Scholar
  242. 242.
    Stefanutti C, Labbadia G, Morozzi C. Severe hypertriglyceridemia-related acute pancreatitis. Ther Apher Dial. 2013;17(2):130–7.Google Scholar
  243. 243.
    Henderson SR, et al. Severe hypertriglyceridaemia in Type 2 diabetes mellitus: beneficial effect of continuous insulin infusion. QJM. 2013;106(4):355–9.Google Scholar
  244. 244.
    Anderson F, Mbatha SZ, Thomson SR. The early management of pancreatitis associated with hypertriglyceridaemia. S Afr J Surg. 2011;49(2):82–4.Google Scholar
  245. 245.
    Al-Humoud H, Alhumoud E, Al-Hilali N. Therapeutic plasma exchange for acute hyperlipidemic pancreatitis: a case series. Ther Apher Dial. 2008;12(3):202–4.Google Scholar
  246. 246.
    Chen JH, et al. Therapeutic plasma exchange in patients with hyperlipidemic pancreatitis. World J Gastroenterol. 2004;10(15):2272–4.PubMedPubMedCentralGoogle Scholar
  247. 247.
    Gubensek J, et al. Treatment of hyperlipidemic acute pancreatitis with plasma exchange: a single-center experience. Ther Apher Dial. 2009;13(4):314–7.Google Scholar
  248. 248.
    Gubensek J, et al. Factors affecting outcome in acute hypertriglyceridemic pancreatitis treated with plasma exchange: an observational cohort study. PLoS One. 2014;9(7), e102748.PubMedPubMedCentralGoogle Scholar
  249. 249.
    Kadikoylu G, Yavasoglu I, Bolaman Z. Plasma exchange in severe hypertriglyceridemia a clinical study. Transfus Apher Sci. 2006;34(3):253–7.Google Scholar
  250. 250.
    Kyriakidis AV, et al. Management of acute severe hyperlipidemic pancreatitis. Digestion. 2006;73(4):259–64.Google Scholar
  251. 251.
    Yeh JH, Chen JH, Chiu HC. Plasmapheresis for hyperlipidemic pancreatitis. J Clin Apher. 2003;18(4):181–5.Google Scholar
  252. 252.
    Freeman ML, et al. Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference. Pancreas. 2012;41(8):1176–94.PubMedPubMedCentralGoogle Scholar
  253. 253.
    Adler DG, et al. Conservative management of infected necrosis complicating severe acute pancreatitis. Am J Gastroenterol. 2003;98(1):98–103.Google Scholar
  254. 254.
    Rodriguez JR, et al. Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients. Ann Surg. 2008;247(2):294–9.PubMedPubMedCentralGoogle Scholar
  255. 255.
    Hartwig W, et al. Reduction in mortality with delayed surgical therapy of severe pancreatitis. J Gastrointest Surg. 2002;6(3):481–7.PubMedPubMedCentralGoogle Scholar
  256. 256.
    Runzi M, et al. Severe acute pancreatitis: nonsurgical treatment of infected necroses. Pancreas. 2005;30(3):195–9.PubMedPubMedCentralGoogle Scholar
  257. 257.
    Garg PK, et al. Primary conservative treatment results in mortality comparable to surgery in patients with infected pancreatic necrosis. Clin Gastroenterol Hepatol. 2010;8(12):1089–94. e2.PubMedPubMedCentralGoogle Scholar
  258. 258.
    Rau BM, et al. Role of early multisystem organ failure as major risk factor for pancreatic infections and death in severe acute pancreatitis. Clin Gastroenterol Hepatol. 2006;4(8):1053–61.PubMedPubMedCentralGoogle Scholar
  259. 259.
    van Baal MC, et al. The role of routine fine-needle aspiration in the diagnosis of infected necrotizing pancreatitis. Surgery. 2014;155(3):442–8.PubMedPubMedCentralGoogle Scholar
  260. 260.
    Beger HG, et al. Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology. 1986;91(2):433–8.PubMedPubMedCentralGoogle Scholar
  261. 261.
    Villatoro E, Mulla M, Larvin M. Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev. 2010;5, CD002941.Google Scholar
  262. 262.
    Villatoro E, Bassi C, Larvin M. Antibiotic therapy for prophylaxis against infection of pancreatic necrosis in acute pancreatitis. Cochrane Database Syst Rev. 2006;4, CD002941.Google Scholar
  263. 263.
    Olah A, et al. Alternative treatment modalities of infected pancreatic necrosis. Hepatogastroenterology. 2006;53(70):603–7.Google Scholar
  264. 264.
    Sivasankar A, et al. Outcome of severe acute pancreatitis: is there a role for conservative management of infected pancreatic necrosis? Hepatobiliary Pancreat Dis Int. 2006;5(4):599–604.Google Scholar
  265. 265.
    Bruennler T, et al. Outcome of patients with acute, necrotizing pancreatitis requiring drainage-does drainage size matter? World J Gastroenterol. 2008;14(5):725–30.PubMedPubMedCentralGoogle Scholar
  266. 266.
    van Baal MC, et al. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis. Br J Surg. 2011;98(1):18–27.Google Scholar
  267. 267.
    Connor S, et al. Surgery in the treatment of acute pancreatitis – minimal access pancreatic necrosectomy. Scand J Surg. 2005;94(2):135–42.Google Scholar
  268. 268.
    Raraty MG, et al. Minimal access retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach. Ann Surg. 2010;251(5):787–93.Google Scholar
  269. 269.
    Seifert H, et al. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis. Lancet. 2000;356(9230):653–5.Google Scholar
  270. 270.
    Bakker OJ, et al. Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial. JAMA. 2012;307(10):1053–61.Google Scholar
  271. 271.
    Pelaez-Luna M, et al. Disconnected pancreatic duct syndrome in severe acute pancreatitis: clinical and imaging characteristics and outcomes in a cohort of 31 cases. Gastrointest Endosc. 2008;68(1):91–7.Google Scholar
  272. 272.
    Deviere J, et al. Complete disruption of the main pancreatic duct: endoscopic management. Gastrointest Endosc. 1995;42(5):445–51.Google Scholar
  273. 273.
    Arvanitakis M, et al. Pancreatic-fluid collections: a randomized controlled trial regarding stent removal after endoscopic transmural drainage. Gastrointest Endosc. 2007;65(4):609–19.Google Scholar
  274. 274.
    Trevino JM, Tamhane A, Varadarajulu S. Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections. J Gastroenterol Hepatol. 2010;25(3):526–31.PubMedPubMedCentralGoogle Scholar
  275. 275.
    Mohamed SR, Siriwardena AK. Understanding the colonic complications of pancreatitis. Pancreatology. 2008;8(2):153–8.PubMedPubMedCentralGoogle Scholar
  276. 276.
    Gardner A, Gardner G, Feller E. Severe colonic complications of pancreatic disease. J Clin Gastroenterol. 2003;37(3):258–62.PubMedPubMedCentralGoogle Scholar
  277. 277.
    Van Minnen LP, et al. Colonic involvement in acute pancreatitis. A retrospective study of 16 patients. Dig Surg. 2004;21(1):33–8; discussion 39–40.PubMedPubMedCentralGoogle Scholar
  278. 278.
    Aldridge MC, et al. Colonic complications of severe acute pancreatitis. Br J Surg. 1989;76(4):362–7.PubMedPubMedCentralGoogle Scholar
  279. 279.
    Gondal B, et al. Perforation of the descending colon in severe acute pancreatitis: a case report and literature review. Pancreas. 2014;43(3):488–90.PubMedPubMedCentralGoogle Scholar
  280. 280.
    Aghenta AA, Kim HJ. An unusual case of colon perforation complicating acute pancreatitis. Case Rep Gastroenterol. 2009;3(2):207–13.PubMedPubMedCentralGoogle Scholar
  281. 281.
    Nagpal AP, Soni H, Haribhakti S. Severe colonic complications requiring sub-total colectomy in acute necrotizing pancreatitis-a retrospective study of 8 patients. Indian J Surg. 2015;77(1):3–6.PubMedPubMedCentralGoogle Scholar
  282. 282.
    Ho HS, Frey CF. Gastrointestinal and pancreatic complications associated with severe pancreatitis. Arch Surg. 1995;130(8):817–22; discussion 822–3.PubMedPubMedCentralGoogle Scholar
  283. 283.
    Mallick IH, Winslet MC. Vascular complications of pancreatitis. JOP. 2004;5(5):328–37.PubMedPubMedCentralGoogle Scholar
  284. 284.
    Easler J, et al. Portosplenomesenteric venous thrombosis in patients with acute pancreatitis is associated with pancreatic necrosis and usually has a benign course. Clin Gastroenterol Hepatol. 2014;12(5):854–62.PubMedPubMedCentralGoogle Scholar
  285. 285.
    Verde F, Fishman EK, Johnson PT. Arterial pseudoaneurysms complicating pancreatitis: literature review. J Comput Assist Tomogr. 2015;39(1):7–12.PubMedPubMedCentralGoogle Scholar
  286. 286.
    Butler JR, et al. Natural history of pancreatitis-induced splenic vein thrombosis: a systematic review and meta-analysis of its incidence and rate of gastrointestinal bleeding. HPB (Oxford). 2011;13(12):839–45.Google Scholar
  287. 287.
    Park WS, et al. Should anticoagulants be administered for portal vein thrombosis associated with acute pancreatitis? World J Gastroenterol. 2012;18(42):6168–71.PubMedPubMedCentralGoogle Scholar
  288. 288.
    Aswani Y, Hira P. Venous complications of pancreatitis: a review. JOP. 2015;16(1):20–4.PubMedPubMedCentralGoogle Scholar
  289. 289.
    Ponziani FR, et al. Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment. World J Gastroenterol. 2010;16(2):143–55.PubMedPubMedCentralGoogle Scholar
  290. 290.
    Balthazar EJ, Fisher LA. Hemorrhagic complications of pancreatitis: radiologic evaluation with emphasis on CT imaging. Pancreatology. 2001;1(4):306–13.PubMedPubMedCentralGoogle Scholar
  291. 291.
    Tessier DJ, et al. Clinical features and management of splenic artery pseudoaneurysm: case series and cumulative review of literature. J Vasc Surg. 2003;38(5):969–74.PubMedPubMedCentralGoogle Scholar
  292. 292.
    Bedioui H, et al. Pseudoaneurysm of the splenic artery presenting with gastrointestinal bleeding. J Emerg Med. 2010;38(3):317–9.PubMedPubMedCentralGoogle Scholar
  293. 293.
    Yamaguchi K, et al. Pancreatic pseudoaneurysm converted from pseudocyst: transcatheter embolization and serial CT assessment. Radiat Med. 2000;18(2):147–50.PubMedPubMedCentralGoogle Scholar
  294. 294.
    Bretagne JF, et al. Pseudoaneurysms and bleeding pseudocysts in chronic pancreatitis: radiological findings and contribution to diagnosis in 8 cases. Gastrointest Radiol. 1990;15(1):9–16.PubMedPubMedCentralGoogle Scholar
  295. 295.
    Dorffel T, et al. Vascular complications in acute pancreatitis assessed by color duplex ultrasonography. Pancreas. 2000;21(2):126–33.PubMedPubMedCentralGoogle Scholar
  296. 296.
    Boudghene F, L’Hermine C, Bigot JM. Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol. 1993;4(4):551–8.PubMedGoogle Scholar
  297. 297.
    Flati G, et al. Severe hemorrhagic complications in pancreatitis. Ann Ital Chir. 1995;66(2):233–7.PubMedGoogle Scholar
  298. 298.
    Gambiez LP, et al. Arterial embolization for bleeding pseudocysts complicating chronic pancreatitis. Arch Surg. 1997;132(9):1016–21.PubMedGoogle Scholar
  299. 299.
    de Perrot M, et al. Management of bleeding pseudoaneurysms in patients with pancreatitis. Br J Surg. 1999;86(1):29–32.PubMedGoogle Scholar
  300. 300.
    Savastano S, et al. Arterial complications of pancreatitis: diagnostic and therapeutic role of radiology. Pancreas. 1993;8(6):687–92.PubMedGoogle Scholar
  301. 301.
    Weltz AS, et al. The use of resuscitative endovascular balloon occlusion of the aorta to control hemorrhagic shock during video-assisted retroperitoneal debridement or infected necrotizing pancreatitis. Int J Surg Case Rep. 2015;13:15–8.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 2.5 International License (, which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Authors and Affiliations

  1. 1.Acute Care Surgery, R. Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Acute Care Surgery, R Adams Cowley Shock Trauma CenterUniversity of Maryland Medical CenterBaltimoreUSA

Personalised recommendations