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Acute pancreatitis: update on management

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Acute pancreatitis is a common acute surgical condition. The annual incidence worldwide is 4.9–73.4 cases per 100 000 people,1,2 with the incidence in Australia on the higher end of the spectrum.3 The mortality rate for pancreatitis is between 1.5% and 4.2% in large epidemiological studies,46 but varies according to the severity of pancreatitis, increasing to 30% in those with infected pancreatic necrosis.7 A recent Australian study has reported a low mortality rate of 0.08%,8 thought to be due to earlier recognition of severe pancreatitis and the appropriate use of intensive care support.8

As acute pancreatitis is common, costly and potentially life-threatening it is important that management is guided by an evidence-based approach. The American College of Gastroenterology (ACG) and the International Association of Pancreatology (IAP) in collaboration with the American Pancreatic Association (APA) have recently published new guidelines for the management of acute pancreatitis.9,10 These guidelines reviewed all of the evidence of a wide range…