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Acute Pancreatitis

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Abstract

Acute pancreatitis is a common disease and patients usually present with severe upper abdominal pain. The mild form of the disease is self-limiting, but severe and critical disease is characterized by infected pancreatic necrosis, multiple organ failure and a high mortality [1].

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References

  1. Petrov MS, Shanbhag S, Chakraborty M, Phillips AR, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139:813–20.

    Article  PubMed  Google Scholar 

  2. Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet. 2015;386(9988):85–96.

    Article  PubMed  Google Scholar 

  3. Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87.

    Article  PubMed  Google Scholar 

  4. Banks PA. Epidemiology, natural history, and predictors of disease outcome in acute and chronic pancreatitis. Gastrointest Endosc. 2002;56(6 Suppl):S226–30.

    Article  PubMed  Google Scholar 

  5. Akhtar AJ, Shaheen M. Extrapancreatic manifestations of acute pancreatitis in African-American and Hispanic patients. Pancreas. 2004;29(4):291–7.

    Article  PubMed  Google Scholar 

  6. Lowenfels AB, Maisonneuve P. Acute pancreatitis: is smoking a risk factor for acute pancreatitis. Nat Rev Gastroenterol Hepatol. 2011;8(11):603–4.

    Article  PubMed  Google Scholar 

  7. Premkumar R, Phillips AR, Petrov MS, Windsor JA. The clinical relevance of obesity in acute pancreatitis: targeted systematic reviews. Pancreatology. 2015;15(1):25–33.

    Article  PubMed  Google Scholar 

  8. Acosta JM, Ledesma CL. Gallstone migration as a cause of acute pancreatitis. N Engl J Med. 1974;290(9):484–7.

    Article  CAS  PubMed  Google Scholar 

  9. Lee SP, Nicholls JF, Park HZ. Biliary sludge as a cause of acute pancreatitis. N Engl J Med. 1992;326(9):589–93.

    Article  CAS  PubMed  Google Scholar 

  10. Frick TW. The role of calcium in acute pancreatitis. Surgery. 2012;152(3 Supplement 1):S157–63.

    Article  PubMed  Google Scholar 

  11. Whitcomb DC. Genetics of alcoholic and nonalcoholic pancreatitis. Curr Opin Gastroenterol. 2012;28(5):501–6.

    Article  PubMed  Google Scholar 

  12. Elmunzer BJ, Schelman JM, Lehman GA, et al. A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis. N Engl J Med. 2012;366:1414–22.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Akbar A, Abu Dayyeh BK, Baron TH, Wang Z, Altayar O, Murad MH. Rectal non-steroidal anti-inflammatory drugs are superior to pancreatic duct stents in preventing pancreatitis after endoscopic retrograde cholangiopancreatography: a network meta-analysis. Clin Gastroenterol Hepatol. 2013;13:778–83.

    Article  CAS  Google Scholar 

  14. Saluja A, Steer M. Pathophysiology of pancreatitis. Role of cytokines and other mediators of inflammation. Digestion. 1999;60:27–33.

    Article  CAS  PubMed  Google Scholar 

  15. Hofbauer B, Saluja AK, Lerch MM, et al. Intra-acinar cell activation of trypsinogen during caerulein-induced pancreatitis in rats. Am J Phys. 1998;275(2 Pt 1):G352–62.

    CAS  Google Scholar 

  16. Saluja AK, Lerch MM, Phillips PA, Dudeja V. Why does pancreatic overstimulation cause pancreatitis? Annu Rev Physiol. 2007;69:249–69.

    Article  CAS  PubMed  Google Scholar 

  17. Dawra R, Sah RP, Dudeja V, et al. Intra-acinar trypsinogen activation mediates early stages of pancreatic injury but not inflammation in mice with acute pancreatitis. Gastroenterology. 2011;141(6):2210–7. e2212.

    Article  CAS  PubMed  Google Scholar 

  18. Gaiser S, Daniluk J, Liu Y, et al. Intracellular activation of trypsinogen in transgenic mice induces acute but not chronic pancreatitis. Gut. 2011;60(10):1379–88.

    Article  CAS  PubMed  Google Scholar 

  19. Whitcomb DC, Gorry MC, Preston RA, et al. Hereditary pancreatitis is caused by a mutation in the cationic trypsinogen gene. Nat Genet. 1996;14(2):141–5.

    Article  CAS  PubMed  Google Scholar 

  20. Kloppel G, Dreyer T, Willemer S, et al. Human acute pancreatitis: its pathogenesis in the light of immunocytochemical and ultrastructural findings in acinar cells. Virchows Arch A Pathol Anat Histopathol. 1986;409(6):791–803.

    Article  CAS  PubMed  Google Scholar 

  21. Saluja A, Hashimoto S, Saluja M, et al. Subcellular redistribution of lysosomal enzymes during caerulein-induced pancreatitis. Am J Phys. 1987;253(4 Pt 1):G508–16.

    CAS  Google Scholar 

  22. Saluja AK, Bhagat L, Lee HS, et al. Secretagogue-induced digestive enzyme activation and cell injury in rat pancreatic acini. Am J Phys. 1999;276(4 Pt 1):G835–42.

    CAS  Google Scholar 

  23. Dudeja V, Phillips P, Mujumdar N, et al. Heat shock protein 70 inhibits apoptosis in cancer cells by two simultaneous but independent mechanisms. Gastroenterology. 2009;136:1772–82.

    Article  CAS  PubMed  Google Scholar 

  24. Hietaranta AJ, Singh VP, Bhagat L, et al. Water immersion stress prevents caerulein-induced pancreatic acinar cell nf-kappa b activation by attenuating caerulein-induced intracellular Ca2+changes. J Biol Chem. 2001;276(22):18742–7.

    Article  CAS  PubMed  Google Scholar 

  25. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.

    Article  PubMed  Google Scholar 

  26. Windsor JA, Petrov MS. Acute pancreatitis reclassified. Commentary. Gut. 2013;62(1):4–5.

    Article  PubMed  Google Scholar 

  27. Moore FA. Presidential address: imagination trumps knowledge. Am J Surg. 2010;200(6):671–7.

    Article  PubMed  Google Scholar 

  28. Fanous MYZ, Phillips AJP, Windsor JA. Mesenteric lymph: the bridge to future management of critical illness. J Pancreas. 2007;8(4):374–99.

    Google Scholar 

  29. Flint R, Windsor JA. Early physiological response to intensive care as a clinically relevant approach to predicting the outcome in severe acute pancreatitis. Arch Surg. 2004;139(4):438–43.

    Article  PubMed  Google Scholar 

  30. Working Party of British Society of Gastroenterology, Association of Surgeons of Great Britain and Ireland, Pancreatic Society of Great Britain and Ireland, Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis. Gut. 2005;54(Suppl 3):iii1–9.

    Google Scholar 

  31. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4 Suppl 2):e1–15.

    Google Scholar 

  32. Forsmark CE, Vege SS, Wilcox CM. Acute pancreatitis. N Engl J Med. 2016;375(20):1972–81.

    Article  CAS  PubMed  Google Scholar 

  33. Rompianesi G, Hann A, Komolafe O, Pereira SP, Davidson BR, Gurusamy KS. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis. Cochrane Database Syst Rev. 2017.; Issue 4. Art. No.: CD012010. https://doi.org/10.1002/14651858.CD012010.pub2.

  34. Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379–400.

    Article  PubMed  Google Scholar 

  35. Gardner TB, Vege SS, Pearson RK, Chari ST. Fluid resuscitation in acute pancreatitis. Clin Gastroenterol Hepatol. 2008;6:1070–6.

    Article  PubMed  Google Scholar 

  36. Haydock M, Mittal A, Petrov M, Windsor JA. Fluid therapy in acute pancreatitis – anybody’s guess. Ann Surg. 2012. https://doi.org/10.1097/SLA.0b013e31827773ff.

  37. Wilms H, Mittal A, Haydock MD, van den Heever M, Devaud M, Windsor JA. A systematic review of goal directed fluid therapy: rating of evidence for goals and monitoring methods. J Crit Care. 2014;29(2):204–9.

    Article  PubMed  Google Scholar 

  38. Wu BU, Hwang JQ, Gardner TB, 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.

    Article  PubMed  Google Scholar 

  39. Fink MP. Bench to bedside: cytopathic hypoxia. Crit Care. 2002;6(6):491–9.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Windsor JA, Johnson CD, Petrov MS, Layer P, Garg PK, Papachristou GI. Classifying the severity of acute pancreatitis: towards a way forward. Pancreatology. 2015;15(2):101–4.

    Article  CAS  PubMed  Google Scholar 

  41. Whitcomb DC. Acute pancreatitis. N Engl J Med. 2006;354:2142–50.

    Article  PubMed  Google Scholar 

  42. Papachristou GI, Muddana V, Yadav D, O’Connell M, Sanders MK, Slivka A, Whitcomb DC. 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.

    Article  PubMed  Google Scholar 

  43. Mofidi R, Duff MD, Wigmore SJ, et al. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. Br J Surg. 2006;93:738–44.

    Article  CAS  PubMed  Google Scholar 

  44. Lankisch PG, Weber-Dany B, Hebel K, Maisonneuve P, Lowenfels AB. The harmless acute pancreatitis score: a clinical algorithm for rapid initial stratification of non-severe disease. Clin Gastroenterol Hepatol. 2009;7:702–5.

    Article  PubMed  Google Scholar 

  45. Talukdar R, Sharma M, Deka A, Teslima S, Goswami AD, Goswami A, Baro A, Reddy DN. Utility of “harmless acute pancreatitis score”in predicting a non-severe course of acute pancreatitis: a pilot study in an Indian cohort. Indian J Gastroenterol. 2014;33(4):316–21.

    Article  PubMed  Google Scholar 

  46. Yang Z, Dong L, Shang Y, Yang C, Gou S, Li Y, Xiong J, Wu H, Wang C. Prediction of severe acute pancreatitis using a decision tree model based on the revised Atlanta classification of acute pancreatitis. PLoS One. 2015;10(11):e0143486. https://doi.org/10.1371/journal.pone.0143486.

  47. Windsor JA. Assessment of the severity of acute pancreatitis: no room for complacency. Pancreatology. 2008;8(2):105–9.

    Article  PubMed  Google Scholar 

  48. Petrov MS, Windsor JA. Classification of the severity of acute pancreatitis: how many categories make sense? Am J Gastroenterol. 2010;105(1):74–7.

    Article  PubMed  Google Scholar 

  49. Dellinger EP, Forsmark CE, Layer P, et al. Determinants-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg. 2012;256:875–80.

    Article  PubMed  Google Scholar 

  50. Acevedo-Piedra NG, Moya-Hoyo N, Rey-Riveiro M, Gil S, Sempere L, Martinez J, et al. Validation of the determinant-based classification and revision of the Atlanta classification systems for acute pancreatitis. Clin Gastroenterol Hepatol. 2014;12:311–6.

    Article  PubMed  Google Scholar 

  51. Al-Omran M, Albalawi ZH, Tashkandi MF, Al-Ansary LA. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev. 2010;20(1):CD002837. https://doi.org/10.1002/14651858.

    Article  Google Scholar 

  52. Li X, Ma F, Jia K. Early enteral nutrition within 24 hours or between 24 and 72 hours for acute pancreatitis: evidence based on 12 RCTs. Med Sci Monit. 2014;20:2327–35.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  53. Bakker OJ, van Brunschot S, van Santvoort HC, et al. Early versus on-demand nasoenteric tube feeding in acute pancreatitis. N Engl J Med. 2014;371:1983–93.

    Article  CAS  PubMed  Google Scholar 

  54. Singh N, Sharma B, Sharma M, et al. Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis: a noninferiority randomized controlled trial. Pancreas. 2012;41(1):153–9.

    Article  PubMed  Google Scholar 

  55. Petrov MS, Loveday BP, Pylypchuk RD, McIlroy K, Phillips AR, Windsor JA. Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg. 2009;96:1243–52.

    Article  CAS  PubMed  Google Scholar 

  56. Petrov MS, van Santvoort HC, Besselink MG, et al. Early endoscopic retrograde cholangiopancreatography versus conservative management in acute biliary pancreatitis without cholangitis: a meta-analysis of randomized trials. Ann Surg. 2008;247(2):250–7.

    Article  PubMed  Google Scholar 

  57. Kraft M, Lerch MM. Gallstone pancreatitis: when is endoscopic retrograde cholangiopancreatography truly necessary? Curr Gastroenterol Rep. 2003;5:125–32.

    Article  PubMed  Google Scholar 

  58. Wittau M, Mayer B, Scheele J, et al. Systematic review and meta-analysis of antibiotic prophylaxis in severe acute pancreatitis. Scand J Gastroenterol. 2011;46(3):261–70.

    Article  PubMed  Google Scholar 

  59. Van Baal MC, van Santvoort HC, Bollen TL, et al. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis. Br J Surg. 2011;98(1):18–27.

    Article  PubMed  Google Scholar 

  60. Freeman M, Werner J, van Santvoort HC, et al. Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference. Pancreas. 2012;41:1176–94.

    Article  PubMed  Google Scholar 

  61. Van Santvoort HC, Besselink MG, Bakker OJ, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010;362(16):1491–502.

    Article  PubMed  Google Scholar 

  62. Bakker OJ, van Santvoort HC, van Brunschot S, et al. Endoscopic transgastric versus surgical necrosectomy for infected necrotizing pancreatitis: a randomized trial. JAMA. 2012;307:1053–61.

    Article  CAS  PubMed  Google Scholar 

  63. Nealon WH, Walser E. Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage). Ann Surg. 2002;235(6):751–8.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53:1340–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  65. Van Baal MC, Besselink MG, Bakker OJ, et al. Timing of cholecystectomy after mild biliary pancreatitis: a systematic review. Ann Surg. 2012;255(5):860–6.

    Article  PubMed  Google Scholar 

  66. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Windsor, J.A. (2018). Acute Pancreatitis. In: Barreto, S., Windsor, J. (eds) Surgical Diseases of the Pancreas and Biliary Tree. Springer, Singapore. https://doi.org/10.1007/978-981-10-8755-4_9

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  • DOI: https://doi.org/10.1007/978-981-10-8755-4_9

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